FLPIC - Capitol Updates

Read Florida Partners in Crisis Capitol Updates to keep abreast of key developments in criminal justice, mental health and substance abuse policy

Capitol Update Keeps You Informed

Legislators begin their work for the 2013 legislative session through a series of public committee hearings held in Tallahassee. Committee hearings are scheduled for the weeks of January 14, 21, and February 4, 11 and 18. The 2013 session is scheduled for Tuesday, March 5 through Friday, May 3. The public is welcome and encouraged to attend these meetings to provide input on policy deliberations. Florida Partners in Crisis will be monitoring these hearings, providing testimony and sending updates to our members via our Capitol Update electronic newsletter. If you are not currently receiving Capitol Update, please complete a Membership form and we will add your information to our distribution list.

2013 Legislative Committee Week Summary

Summary provided by Shane Messer, Florida Council for Community Mental Health
February 22, 2013

This week was the final committee week before the official start of the 2013 Session. Governor Scott surprisingly announced his support of Medicaid expansion; state agencies presented their 5% budget reduction exercise in each appropriate Senate committee including DCF in the Health and Human Services Appropriations Committee; the House held a work shop regarding ALF regulations, heard a presentation on substance abuse and passed a few bills.

Legislators scrambled to collect last minute campaign checks (they are not allowed to raise funds during Session) with Council staff attending events for Rep. Young and Senator Garcia.

Representative Darryl Rouson was elected Minority Leader in the House as well this week.

The legislators will be spending this week in their district offices and will return to Tallahassee Tuesday, March 5^th for the 1^st day of our 60 day Session.

HOUSE CIVIL JUSTICE SUBCOMMITTEE - HB9

HB9, Involuntary Examinations under the Baker Act, passed out of committee. This bill authorizes physician assistants & advanced registered nurse practitioners to initiate involuntary examinations under Baker Act of persons believed to have mental illness. Although the bill passed the committee there was much debate from members as to whether physician assistants should be included. The bill sponsor, Representative Campbell, was told to have more information regarding PAs behavioral health care education by the next committee. Please let Council staff know if you have any opposition to this bill

Link to bill: http://www.myfloridahouse.gov/Sections/Bills/bills.aspx

SENATE HEALTH POLICY COMMITTEE – SB398

SB 398 expanding the authorizing of physician assistants to execute all practice-related activities delegated by a supervisory physician and expanding their authority to order medications passed out of committee Thursday as a committee substitute. The strike all amendment was technical in nature

SENATE HEALTH AND HUMAN SERVICES APPROPRIATIONS SUBCOMMITTEE - DCF BUDGET REDUCTION EXERCISE & SPECIAL PROJECTS

On Thursday, the Senate HHS Committee discussed two issues: the Medicaid Low Income Pool and the State Agency Required 5% Reductions. The Department of Children and Families, the Department of Health, and the Department of Veterans Affairs were on the agenda this week. The 5% reduction is an exercise mandated by statute and annually reviewed by the Governor and Legislature.

Dr. Nevin Smith presented DCF’s thirty-two issues that the department included in its reduction exercise. Several of the areas proposed for reductions were reversions of funding not being spent in FY 2012-13 and have little impact on savings. Proposed mental health and substance abuse service reductions include $1,126,770 in mental health service reversions, $36,999 in substance abuse service reversions, $5,500,000 from the closing of Northeast Florida State Hospital, $38,752,119 in a mental health and substance abuse services budget reduction, and $2,100,000 from closing West Florida Community Care. Dr. Smith pointed out that none of these reductions were included in the Governor’s FY 2013-14 Budget and were not what the department wanted to do. They were simply presented to comply with the budget reduction exercise. Other recommendations included cuts in other program areas and over 146 FTEs in unfunded positions.

Senator Sobel expressed concern about the mental health and substance abuse cuts but was more concerned with the cut in Domestic Violence programs since it equated to a 10% reduction in that program area.

Senator Sobel believes that the mental health and substance abuse cuts would not be as dramatic because of the mental health and substance abuse benefits being included in ACA so some education needs to be done on this issue with her and other committee members. Most committee members showed more concern for cuts in the Department of Health especially dental services.

Senator Grimsley, chair, did not comment on the Agencies’ proposed cuts but did end the committee with the comment that at this point all special projects have been zeroed out in the committee’s base budget and would not be put back into the budget unless HHS Committee members specifically spoke to her about wanting to keep them. Committee members were also told they could recommend other special projects. Council members with these projects have been alerted to the action they need to take over the next week.

Link to packet, budget reduction exercise: http://www.flsenate.gov/PublishedContent/Committees/2012-2014/AHS/MeetingRecords/MeetingPacket_2044.pdf

The Governor announced his official support of Medicaid Expansion. Senate President Gaetz came out with an official statement stating the Senate was still conducting meeting reviewing state options. “The Senate Select Committee on PPACA is in the process of completing its thorough review of state options associated with federal health care reform. Senator Joe Negron, Chair of our PPACA Select Committee, anticipates that the committee will complete its work and be prepared to offer recommendations for consideration by the full Senate towards the beginning of the 2013 Session. I’m eager to read their recommendations and look forward to working with our partners in the House and with Governor Scott on the right solution for Florida”.

SELECT PATIENT PROTECTION & AFFORDABLE CARE ACT (PPACA)

While House Speaker Weatherford came right out and announced that he would not support Expansion. “Governor Scott has made his decision and I certainly respect his thoughts. However, the Florida Legislature will make the ultimate decision. I am personally skeptical that this inflexible law will improve the quality of healthcare in our state and ensure our long-term financial stability. The House of Representatives has a bipartisan select committee that is currently meeting regularly on this issue. I look forward to the recommendations that our select committee will bring forth in the next few weeks. I am confident that our actions will be based on principle and rooted in facts”.

Amy Baker, Chief Legislative Economist, presented to both the House and the Senate. Her presentation laid out the conflicts between PPACA and Current Florida law.

Link to her presentation: http://www.flsenate.gov/PublishedContent/Committees/2012-2014/SPPA/MeetingRecords/MeetingPacket_2053.pdf

In the Senate Joint PPACA committee meeting, Senator Negron called for a discussion on the PPACA exchange decision by the. All members indicated they would like to move forward with the Federal exchange with a "wait and see" approach at this time. It was suggested earlier on by Senator Soto that Florida set up some sort of infrastructure to eventually gain the capability to operate an exchange state-wide on its own in the future. Senator Bean was in favor of a Federal exchange due to there being many unknowns at this time. Several remarks about "not being the first one to walk through a minefield" were made by Senators to describe their reluctance for a state exchange. Senator Negron moved that a formal letter be sent to Senate President Gaetz on behalf of the committee preference.

Link to packet: http://www.flsenate.gov/PublishedContent/Committees/2012-2014/SPPA/MeetingRecords/MeetingPacket_2053.pdf

In the House, Mark Robitaillie, CEO of Martin Health Systems and incoming Florida Hospital Association President told the panel that more than 50 percent of adults under age 65 lack health insurance. “The majority of the uninsured are working, employed in the service and retail industries and are in relatively low-paying jobs,” Robitaillie said. He said last year MHS provided more than $24 million in care for which it was not paid. Starting in 2014, the ACA calls for states to expand Medicaid coverage to individuals making up to about $15,500 a year. Economists estimated there are about 800,000 Floridians who fall into that category and would become eligible. The expansion is optional and Amy Baker, the Legislature’s chief economist, told the committee it would cost about $343 per individual a month to provide them with Medicaid coverage. The federal government would pick up 100 percent of the cost of adding previously ineligible individuals for the first three years and 90 percent of the cost afterward. Lawmakers, though, appeared worry about unintended consequences. Rep. Matt Hudson, R-Naples, observed that the three hospital executives who participated in a panel discussion with the committee said some of the cost of uncompensated care is shifted to private insurers. Hudson wondered whether moving the working poor into Medicaid would hurt the hospital’s bottom line.

Link to packet: http://www.myfloridahouse.gov/Sections/Committees/committeesdetail.aspx?SessionId=73&CommitteeId=2738

HOUSE HEALTHY FAMILIES SUBCOMMITTEE-SUBSTANCE ABUSE PRESENTATION

Rob Siedlecki, Assist. Secretary for Substance Abuse and Mental Health, DCF, Mark Fontaine, Executive Director, FADAA and Nancy Hamilton, President/CEO of Operation Inc., testified on substance use disorders. Siedlecki provided an overview on addiction disorders, the amount of co-occurring between mental health and substance abuse, and the types of services, individuals served, and costs of DCF services. He briefly discussed MEs as well. Fontaine more thoroughly covered the field of addictions and the brain science behind it. Hamilton did a great job bringing it all down to earth explaining why people become addicted, the affects of addictions, and the barriers to treatment. Many representatives acknowledged the importance of SAMH issues in their communities. This week’s testimony was a follow-up to the mental health testimony held last week and concludes the sub-committee’s pre-session agenda.

Link to packet: http://www.myfloridahouse.gov/Sections/Committees/committeesdetail.aspx?SessionId=73&CommitteeId=2717

HOUSE HEALTH INNOVATION SUBCOMMITTEE - ALF WORSHOP

The committee heard the same presentation given to Senate Children, Families, and Elder Affairs a few weeks ago on ALFs. Larry Polivka, Chair of the Governor’s ALF workgroup (that Bob Sharpe is a part of) gave the committee the workgroup’s recommendations. AHCA also presented. The committee Chair, Representative Wood, announced that the committee would come out with a committee bill concerning ALFs. Council staff is following up with committee staff to address the mental health portion of the proposed bill. Our ideas and concerns fall in line with the Governor’s workgroup’s recommendations.

Link to packet: http://www.myfloridahouse.gov/Sections/Committees/committeesdetail.aspx?SessionId=73&CommitteeId=2715