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2017 Legislative Session –
Legislative Bulletin
Week Four: March 31, 2017

2017 Legislative Session—Stay Informed!
LeadingAge Florida continues to host our weekly Legislative Session Weekly Briefing conference call which will continue every Friday at 10:00 am EDT through the end of Session. To participate:

Call in number: 1-866-200-9760
Participant Pin: 7020321#

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.

LeadingAge Florida 2017 Public Policy Priorities

  • Medicaid Prospective Payment System for Nursing Homes - Oppose the final model recommended by Navigant in the report to the Governor and Legislature, motivate LeadingAge Florida members to vigorously advocate against the implementation of the new payment plan, and present a fully developed alternative model incorporating the positive aspects of the Navigant plan without disrupting the current level of quality care provided.
  • Preserve the Certificate of Need for Nursing Homes.
  • Support FLiCRA’s proposed legislative changes to Chapter 651, FS, as modified by LeadingAge Florida’s internal workgroup.
  • Oppose the Office of Insurance Regulation’s proposed changes to chapter 651, F.S., until all stakeholders are involved in the process and have the opportunity to identify necessary changes and participate in the development of statutory language.
  • Use Housing Trust Funds for their Intended Purpose
  • Support initiatives for innovative senior housing plus services models.

Activity on LeadingAge Florida Issues/Priority Bills

Medicaid Prospective Payment System for Nursing Homes
This week, the Senate Health and Human Services Appropriation Subcommittee passed a budget proposal that includes the Florida Health Care Association prospective payment system proposal. The House budget that was also released this week does not include a PPS proposal. The next stop in the Senate will be April 5 and 6, when it will come before the full Senate Appropriations Committee for a vote.

During this week’s Senate HHS Subcommittee hearing, LeadingAge Florida members Marty Goetz, of River Garden Hebrew Home, and Kip Corriveau, of Bon Secours, and President/CEO Steve Bahmer, testified very effectively in opposition to the plan. Their comments were sufficient to raise doubts among committee members about the readiness of the plan, and there clearly is still confusion among committee members about the potential impacts of the FHCA model. However, the Subcommittee ultimately decided to approve the plan as part of the budget to put it in a posture for budget negotiations between the House and Senate.

LeadingAge Florida’s most recent Call to Action asks our members to reach out to the full Senate Appropriations Committee with this simple message: This plan DOES NOT have consensus among nursing home providers and would negatively impact quality nursing homes across the State of Florida.

Please click here for talking points, legislator contact information and more information on how you can help by reaching out to Senate and House members, We need for your voice to be heard now!
you can take to help us advocate for a payment system that is fair and equitable and rewards quality.

Certificate of Need for Nursing Homes
There has been no further movement on the House and Senate bills that include the repeal the CON requirements for nursing homes. As previously advised HB 7 has passed two committees of reference and has one final stop – the House Health & Human Services Committee. No further action was taken on HB 7 this week. SB 676 has been referred to four committees of reference and has not yet been heard in the first committee of reference. At this point in the Session, these bills are stalled and it appears that they will remain in committee.

Continuing Care Community Regulatory Reform
LeadingAge Florida opposes the Office of Insurance Regulation’s proposed changes to chapter 651, F.S., until all stakeholders are involved in the process and have the opportunity to identify necessary changes and participate in the development of statutory language. The OIR’s legislative proposal was filed as SB 1430 by Sen. Tom Lee and HB 1349 by Rep. Cyndi Stevenson.

The bills have not been scheduled for a committee hearing in either the House or the Senate. And time has essentially run out for bills that have not been heard in at least one committee of reference. At this point in the legislative session, we don’t anticipate either bill moving forward.

Affordable Senior Housing
LeadingAge Florida has prepared an amendment to SB 854 by Sen. Jeff Brandes and HB 1013 by Rep. Newton adding a representative of LeadingAge Florida to the affordable housing task force created in the bills.

SB 854 and HB 1013 both have passed their first committees of reference but have not yet been scheduled for another committee hearing.

The Senate Appropriations Bill and Implementing Bill include the provisions of these bills creating the Affordable Housing Task Force in the budget. We are working to amend the language to include a representative of LeadingAge Florida on the task force.

Activity on LeadingAge Florida Monitored Bills

Medicaid Managed Care
SB 682 by Sen. Stargel exempts Medicaid recipients who have resided in a nursing facility for 60 or more consecutive days, with certain exceptions, from the Long-Term Care component (LTC) of the Statewide Medicaid Managed Care (SMMC) program. The bill also exempts those recipients in the LTC component who are receiving hospice care while residing in a nursing facility. These recipients would receive long-term care services through fee-for-service Medicaid providers and other medical services through the managed medical assistance component (MMA) of the SMMC program.

The bill was heard in its first committee of reference this week, amended, and passed by the committee. Amendments adopted to the bill, in part, require a nursing home to be prepared to confirm for the AHCA whether a nursing home resident, who is a Medicaid recipient or whose Medicaid eligibility is pending, is a candidate for Home and Community Based Services (HCBS), by the resident’s 50th consecutive day of residency in the nursing home facility. It also provides that a nursing facility resident is not exempt from the LTC managed care program if the resident has been identified as a candidate for HCBS by the nursing facility administrator and any LTC case manager assigned to the resident.

SB 916 by Sen. Grimsley relating to the Statewide Medicaid Managed Care program passed its first committee of reference this week. The bill deletes the fee-for-service reimbursement option for provider service networks (PSNs), and combines regions, re-groups counties within new regions, and revises the plan limitations within the regions for the procurement process for the Medicaid Managed Medical, among other provisions.

Health Care Facility Regulation
HB 1195 by Rep. Alex Miller is the Agency for Health Care Administration’s (AHCA) healthcare regulatory reform package; it clarifies statutory requirements, eliminates confusion, and allows the AHCA to operate more efficiently. According to the sponsor, the proposal strikes the right balance of protecting patients and reducing regulations. It addresses unlicensed activity of assisted living facilities (ALFs). AHCA is charged with regulating any unlicensed ALF activities. Since 2013, AHCA conducted 500 unlicensed investigations confirming at least 200 were in violation. Regulatory action is often difficult and faces many loopholes. The bill makes several changes to close loopholes increasing the ability for AHCA to conduct enforcement regulations.

It also eliminates licensure requirements for clinical laboratories to rely on the federal requirements which are the Clinical Laboratory Improvement Amendments (CLIA) regulations.

HB 1195 passed out of its first committee of reference last week and has two more committees to go. The companion, SB 1760 by Sen. Grimsley was voted favorably in its first committee of reference this week.

Recovery Care Centers
HB 145 by Rep. Renner changes the allowable length of stay in an ASC from less than one working day to no more than 24 hours, which is the federal Medicare length of stay standard. The bill creates a new license for a Recovery Care Center (RCC), defined as a facility the primary purpose of which is to provide recovery care services, to which a patient is admitted and discharged within 72 hours, and which is not part of a hospital.

HB 145 passed the House this week by a vote of 79 Yeas to 34 Nays. It now heads to the Senate where the companion bill, SB 222 by Sen. Steube, includes the extension of time for a patient to stay in an ambulatory surgical center to 24 hours but does not include the recovery care center language. The bill has two more committees of reference and has not yet been scheduled for another hearing.

HB 543 – Regulation of Nursing
HB 543 by Rep. Pigman and SB 328 by Sen. Grimsley relating to the regulation of nursing is a Medical Quality Assurance (“MQA”) bill addressing nursing education. Several years ago, Sen. Grimsley, then Rep. Grimsley, in responding to a nursing shortage relaxed and increased the number of nursing schools available in Florida. It has been largely a successful program. This bill deletes a provision that requires graduates who do not take a licensure exam within 6 months after graduation to complete a licensure examination prep course.

Further, it restores the Board of Nursing (“BON”) authority to conduct on-site evaluation of new program applicants, and restores BON rulemaking authority related to nursing curriculum and program implementation plans. It prohibits a program that has been terminated by the BON from re-opening under a new name for a period of three years. It requires all nursing programs placed on probation status to notify their students and applicants of the implication of that status.

The bill was amended to add some clarifying language to several licensure programs within the Department of Health (“DOH”). Specifically, it grants the DOH the authority to adopt rules to implement the federal Conrad 30 Waiver Program. It authorized the DOH to request a date of birth on application. It requires denial of license or renewal if applicant has outstanding balances due following a disciplinary proceeding.

It permits the waiver of licensure or renewal up to two years for a license profession if the DOH determines revenues will exceed the amount to regulate that profession. It requires pain clinics to register with the DOH. It allows for advances registered nurse practitioners (“ANRP”) to maintain a copy of their protocol at the facility or office where they practice. It allows them to enter into a protocol with at least one physician within that practice. It exempts third party logistic providers who store or fill orders for manufacturers of certain dialysis drugs and supplies from pharmacy licensure.

HB 543 passed its last committee of reference this week. SB 328 was reported favorably in its second committee of reference.

A Week in Review – News from the Capitol
Week Four of the 2017 Session
By Leslie Dughi, Director of Government Law & Policy Greenberg Traurig

The House and Senate released their respective preliminary budgets for FY 2017-18 this week. Most striking is how very far apart the House and Senate are on several significant portions.

On economic incentives, the House budget matched the Speaker’s proposal to eliminate Enterprise Florida (EFI) and drastically cut the Visit Florida budget to $25 million. Further, it does not provide funding for economic development projects or additional economic incentives. The Senate budget maintains funding for EFI and Visit Florida, and increases funding for economic development and incentives.

Education is another area where the Senate and House disagree. The Senate K-12 proposal agrees with Governor Scott and would allow local governments to collect significant dollars from rising property values. The House says this equates to raising taxes and will not follow suit. Instead, the House would roll back the tax rate in order to keep level the local government contribution, which comes from property taxes. On higher education, the Senate would significantly increase funding to state universities and cut community colleges. The House budget calls for college and university cuts and also targets the entities’ use of taxpayer dollars to pay salaries for private foundations’ employees.

Both the House and Senate Appropriations Committees will vote on their Chamber’s budget on Tuesday, April 5. The bills would then head to the floor for members to approve. Following the expected rejection of each other’s proposal, conference committees charged with hammering out a compromise between the two proposals will be appointed by the Speaker and President soon after.

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