2018 Legislative Session—Stay Informed!
This is our weekly Legislative Update/Recap report that will continue through the end of Session. Included with this report is the latest copy of the LeadingAge Florida Legislative Bill Tracking Report.
Activity on LeadingAge Florida Priority Bills
Continuing Care Communities
SB 438 by Sen. Lee/HB 783 by Rep. J. Grant
CS/HB 783 by Rep. J. Grant (R-Tampa) was not heard in the Commerce Committee this week. This was the last meeting of the Commerce Committee. Since the bill is still in committee, it is not available to be heard by the full House, unless it is withdrawn from the committee.
CS/SB 438 was not heard in the Rules Committee this week. We believe this was the last meeting of the Rules Committee for the purpose of hearing bills. That means CS/SB 438 will not be heard by the full Senate, unless it is withdrawn from the committee.
Sen. Lee attempted to move a portion of CS/SB 438 forward in this process by filing language consistent with CS/SB 438 provisions relating to availability, distribution and posting of reports; examination and inspections; and acquisitions as an amendment to SB 622 by Sen. Grimsley relating to Health Care Facility Regulation. SB 622 is the Agency for Health Care Administration’s legislative package and was heard by the Rules Committee on Thursday. In presenting the amendment, Sen. Lee described it as his effort to pull a couple of the key provisions of the CCRC bill that died in committee, to try to do something to help seniors at University Village feel as though the legislature is doing something for them. The amendment provides greater notice requirements to residents and closes loopholes in current law regarding a provider’s duty to cooperate with OIR. The bill sponsor asked Sen. Lee to withdraw the amendment and committed to working with him between now and the Senate Floor to address his concerns. Sen. Lee asked for a vote on the amendment and the amendment failed to pass.
Rep. J. Grant has also taken a provision from CS/HB 783 and prepared it as an amendment to HB 1059 by Rep. Burton relating to Exploitation of a Vulnerable Adult. Rep. Grant’s amendment would require the Department of Children and Families, when it has reason to believe that a vulnerable adult resident of a CCRC has been the victim of abuse, neglect or exploitation, to provide a copy of its investigation to the Office of Insurance Regulation. HB 1059 is on House Special Order Calendar on Friday, March 2.
Thursday afternoon, Senator Tom Lee and Rep. Sean Shaw joined members of FLiCRA at a press conference held to draw attention to the situation at University Village and the efforts to protect residents through the CCRC legislation, and to urge legislators to pass CS/SB 438.
LeadingAge Florida prepared a statement from Steve Bahmer in the event any media outlets reached out to us for a statement. Click here to read the statement. Key points include:
- As a key partner and contributor to SB 438, we have supported the bill throughout the legislative process; it is a thoughtful, balanced approach to help address oversight and regulations concerns, ensuring residents’ investments will be protected and that providers can continue to successfully operate.
- Similarly, LeadingAge Florida supported the companion bill in the House, HB 783, until important provisions that protected residents and providers were removed from the bill. Although we all worked hard to have those provisions restored, our efforts were not successful.
- We are disappointed that it appears SB 438 will not pass this year; however, LeadingAge Florida is committed to continuing our work on improved regulations for CCRC residents and providers in collaboration with legislative members, OIR, FLiCRA and other stakeholders.
Hurricane Preparedness, Response and Recovery
HB 7085 by the House Health & Human Services Committee relating to Health Care Disaster Preparedness and Response passed the House this week and is in Senate Messages.
HB 7085 incorporates some recommendations made by the Select Committee on Hurricane Response and Preparedness relating to emergency management plans and special needs shelters. In an effort to address shortages in special needs shelters reported during Hurricane Irma, the bill expands the list of people who could help out in shelters during an emergency. The bill also requires home health-care providers and nurses to develop emergency management plans for their patients.
As it relates to nursing homes and ALFs, the bill adds components that must be included in the facilities’ comprehensive emergency plans to address inadequacies identified in the facilities’ plans in testimony to the Select Committee. The bill also provides enforcement authority to AHCA to ensure that facilities comply with the new plan requirements and follow their plans during an emergency. Facilities could face $500 fines if they do not have plans and could be subject to disciplinary action for not abiding by details of the plans. The bill also requires local emergency management agencies to establish procedures to allow health care facility staff to travel to and from work during declared curfews.
This week, the House HHS Committee heard Proposed Committee Bill HHS3 relating to Ratification of an Agency for Health Care Administration Rule, the generator rules for nursing homes. The committee voted favorably to file the bill, HB 7099. HB 7099 is scheduled for the House Special Order Calendar on Friday, March 2. The rule is estimated to cost nursing homes $121.3 million over the first five years, and about $66 million can be offset by Medicaid, according to a staff analysis. Agency for Health Care Administration Secretary Justin Senior told committee members that about $25 million of the $66 million Medicaid tab would be borne by the state.
While discussing HB 7099, Committee members asked about the generator rule for ALFs. HHS Committee Chairman Travis Cummings has repeatedly expressed concerns that requiring assisted living facilities to abide by backup power rules would result in an unfunded mandate on some of Florida’s smallest businesses. The 2,951 assisted living facilities in the state would have to spend more than $243 million to comply with the requirements.
Both the proposed nursing home and assisted living facilities rules call for facilities to obtain portable backup power sources like generators, capable of providing 30 square feet of cool space for each resident, and up to 72 hours of fuel on site. Smaller assisted living facilities with less than 17 beds would only be required to keep at least 48 hours of fuel on site. Nursing homes would be required to have equipment that could maintain safe indoor air temperatures for 96 hours after an outage, and set the ambient temperature at 81 degrees. The rules require facilities to comply by July 1, one month after the start of this year's hurricane season.
On Thursday, the Senate Rules Committee heard and passed SB 7028 relating to Ratification of Department of Elderly Affairs Rules (emergency generator) and SB 7030 relating to Ratification of Agency for Health Care Administration Rules (emergency generator). Both bills were heard in and passed by the Senate Appropriations Committee on Friday, March 2. They are scheduled to be heard by the full Senate on Special Order Calendar on the same afternoon.
HB 7087 by House Ways & Means Committee provides for a wide range of tax reductions and modifications designed to directly impact both households and businesses, including an exemption for generators for nursing homes and ALFs. The bill includes the process to be followed to receive the tax exemption and provides that the exemption is limited to a maximum of $15,000 in tax for the purchase of the equipment for any single facility. The exemption takes effect upon becoming a law but is retroactive to July 1, 2017. HB 7087 is on the House Special Order Calendar for Friday, March 2.
The Senate companion, SB 620, was passed by the Senate Appropriations Committee on Friday, March 2.
HB 597 by Rep. Yarborough relating to Health Care Facility Regulation is the Agency for Health Care Administration’s regulatory package for 2018. An amendment has been filed by Rep. Shawn Harrison that preempts the regulation of emergency environmental control of ALFs and nursing homes to the state and supersedes any municipal or county ordinance on this subject. HB 597 is on House Special Order Calendar for Friday, March 2. The Senate companion, SB 622 by Sen. Grimsley, is on the Senate Special Order Calendar for Friday, March 2.
Activity on LeadingAge Florida Monitored Bills
HB 483 by Rep. Yarborough and SB 762 by Sen. Mayfield amend the Unfair Insurance Trade Practices Act that provides an extensive list of unfair methods of competition and unfair or deceptive acts prohibited in the business of insurance. The bill increases the maximum allowed value of gifts given by insurance companies for current or prospective customers from $25 to $100. The bill also puts a $100 limit on the total value of gifts given to a particular person annually.
Included in this provision of law are prohibitions on certain inducements to the purchase of insurance; however, there are also exceptions provided by law. Among the exceptions is authorization for insurers and their agents to offer and make gifts of merchandise up to $25 per gift to an insured, prospective insured, or any person, for the purpose of advertising. This exception restricts the value of the advertising gift to $25, but it does not limit the frequency of giving or the aggregate value of gifts given over any period of time.
HB 483 passed the House last week and has been referenced to Committees in the Senate. SB 762 has passed all of its committees of reference and has been placed on Senate Calendar.
HB 551 by Rep. Burton and SB 906 by Sen. Young provide a public records exemption for health care facilities for building plans, blueprints, schematic drawings, & diagrams of certain health care facilities.
Current law provides an exemption from public records for building plans, blueprints, schematic drawings and diagrams that depict the internal layout or structural elements of an attractions and recreation facility, entertainment or resort complex, industrial complex, retail and service development, office development, or hotel or motel development held by an agency. These bills expand the exemption to hospitals, ambulatory surgical centers, nursing homes, hospices, or intermediate care facilities for the developmentally disabled.
HB 551 passed the House last week and has been referenced to Committees in the Senate. SB 906 has been placed on the Senate Calendar.
HB 987 by Rep. B. Cortes and SB 1328 by Sen. Keith Perry attempt to create more affordable housing in Florida by prohibiting the charging of impact and mobility fees by a local government until five years after development of affordable housing has begun. The bills include recommendations of the Affordable Housing Workgroup created by legislation enacted by the 2017 Legislature, and create the Hurricane Housing Recovery Program (HHRP) and the Recovery Rental Loan Program (RRLP) to expedite the creation of housing in response to needs created by hurricanes.
HB 987 by Rep. Bob Cortes passed the House and has been referred to Senate Committees. SB 1328 passed out of its last committee of reference and is on Senate Calendar.
SB 280 by Sen. Bean relating to Telehealth passed its last committee of reference this week and is on Third Reading in the Senate on Friday, March 2. The bill provides specific authorization for the provision of health care services through telehealth. Telehealth is the provision of health care services using telecommunication technologies, which allows licensed practitioners in one location to diagnose and treat patients at a different location. The bill will remove regulatory ambiguity regarding the provision of health care services using this technology because it is not currently addressed in Florida Statutes. The bill includes some of the recommendations included in a report by the Telehealth Advisory Council, such as requiring health-care practitioners who provide care through telehealth to be licensed. The bill also includes the advisory council’s recommendation to ban the use of telehealth for prescribing controlled substances to treat chronic or nonmalignant pain or to certify patients for medical marijuana treatment.
The House companion, HB 793 by Rep. Massullo has not be heard in committee, which means it is most likely dead for this session.
Budget Update by Dr. Erwin Bodo
Here are the details of the House and Senate long-term care related budget proposals:
- Funding for all caseload increases;
- No cost of living increase for nursing homes;
- Long-Term Care Waiver wait list reduction - 113 clients, $4.7 million;
- Alzheimer’s Disease Initiative wait list reduction - 264 clients, $3 million;
- Community Care for the Elderly wait list reduction – 231 clients, $1.9 million;
- Home Care for the Elderly wait list reduction – 215 clients, $0.8 million; and
- PACE expansion – 30 additional slots each in Miami-Dade, Lee, Collier, Charlotte, and Orange counties.
- Reduces retroactive Medicaid eligibility to 30 days;
- Funding for all caseload increases;
- Nursing home payment adjustment - $130.4 million;
- Nursing home payment transition - $9.8 million;
- Alzheimer’s Disease Initiative wait list reduction - 264 clients, $3 million;
- Community Care for the Elderly wait list reduction – $4.0 million;
- Home Care for the Elderly wait list reduction – $1.0 million; and
- PACE expansion - $20.1 million, including an additional PACE site in Miami-Dade.
The Senate proposed $130 million be directed towards increasing the Quality Incentive from 6% to 7.5% increasing the Direct Care Price under the PPS from 100% of the median to 105% of the median.
The budget conference committee dealing with health and human service issues has met several times over the last three days with the following results:
- The two chambers agreed on the funds allocated for reducing the waitlist in the Home Care for the Elderly program.
- The two chambers agreed on transition funding of $9.8 million for nursing homes. This will allow AHCA to pay nursing homes no less than their September 1, 2016 Medicaid rate.
- The two chambers agreed to use FY 2017-18 budget surplus funds in the nursing home line item for rewarding CMS 5-Star homes on a pro-rata share of the total Medicaid days provided by all nursing facilities that qualify for the incentive payment.
- There is agreement on reducing Medicaid retroactive eligibility to the first day of the month in which the application is made. Currently, the retroactive eligibility period is 90 days.
- There is no agreement on the $130 million enhanced funding for nursing home PPS proposed by the Senate. This issue will be bumped to the two full Appropriations Committee chairs. If they cannot agree, then the Speaker of the House and the Senate President will have to resolve this issue.
The final version of the budget has to be printed by Tuesday to allow legislators to have a 72-hour wait period prior to the final vote in order to finish on time. At this point, it has to be a vote up or down, no more amendments are allowed.
As a practical note, once the final budget is released and is signed by the Governor, the agencies will start their work to implement the new provisions. AHCA will have to modify the Title XIX Long-Term Care Reimbursement Plan, develop a draft rule, hold a rule workshop, and then hold a formal rule hearing. We expect these activities will not conclude before the end of the summer. The new PPS system starts on October 1.
A Week in Review – News from the Capitol
Reaction to the Marjory Stoneman Douglas High School in Parkland, FL, Shooting
The Florida Senate plans to hold a Saturday Session to begin debate on the school safety legislation, SB 7026. While the Senate had planned to take up the measure on Friday, March 2, the Senate sponsor of the bill, Sen. Galvano, wanted additional time to work on the proposal.
The House Speaker, Richard Corcoran, has said that the House will wait until the Senate acts on its proposal before taking up the issue.
There is a growing group of opponents, including Governor Scott, several Democrats, black lawmakers and some parents and students of Marjory Stoneman Douglas High School --- who object to the “school marshal” program in House and Senate proposals. That program could lead to armed teachers in schools.
The legislative proposals also include new gun restrictions that have angered some Republicans and the National Rifle Association.