News from Tallahassee for 3/31/15

The Nurse Will See You Now: Expanded Authority Proposal Gets Moving In Legislature posted on 3/26/15

by Lynn Hatter | WFSU

A plan to expand the powers of nurses hasn’t yet caught on in the legislature, but eased out of a House Health panel Wednesday. The fate of bill remains cloudy, but its sponsor says even if it fails this year—the issue isn’t going away.

After initially stalling last week, a bill that would let nurses see patients without having the oversight of doctors, finally got moving Tuesday. House Bill 547 was the final proposal heard by the Health Innovation Subcommittee, and even though lawmakers approved it on a 9-to-4 vote, unclear whether the bill is enough of a priority, or even if it has enough support—to get through the House. Still, Republican Rep. Cary Pigman says he wants fellow lawmakers to hear him out and, “to recognize it’s a work in progress. It’s likely a multi-year work in progress.”

At issue is how much authority nurses and physician assistants should have in medical care. Right now, advanced nurses can see patients but have to be supervised by a doctor. The bill would allow those highly-trained nurses to work independently. It would also give them more prescription drug authority, and allow them to do mental health evaluations under the state’s involuntary confinement, or Baker Act Law. But that’s going too far, says Dr. Allen Pillersdorf, a cosmetic surgeon and President of the Florida Medical Association:

“This is a divisive bill," Pillersdorf said. " If you just look at this room-- we have the doctors, dental and medical students sitting on the left. We have the nurses, nurse practitioners and physician assistants sitting on the right. This is the wrong direction for medicine, we need to be collaborative.”

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Revised medical marijuana bill moves forward in Florida Senate posted on 3/25/15

by john kennedy | Palm Beach Post

Florida’s long-delayed effort to make a strain of medical marijuana available to patients could be advanced under a measure (SB 7066) approved Tuesday by a state Senate panel.

Patients suffering from Parkinson’s disease, AIDS, HIV and multiple sclerosis were among those added to the list of eligible users of a marijuana derivative dubbed Charlotte’s Web by the Regulated Industries Committee.

Senators also agreed to changes that advocates say could help end legal challenges that stalled the introduction of the liquid, non-euphoric pot that was supposed to be made available starting Jan. 1.

“We hope this will bring clarity to a muddied situation,” said Sen. Rob Bradley, R-Fleming Island, who sponsored last year’s legislation and conceded he has been frustrated by the delayed rollout.

The legislation (SB 7066) would expand the number of plant nurseries that could grow the Charlotte’s Web from five to 20. Licenses potentially could be made available through the state Department of Health within two months of the bill becoming law.

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Bill Creating Needle Exchange Pilot Program Passes First Senate Panel posted on 3/24/15

by Sascha Cordner | WFSU

A bill establishing a needle exchange pilot program in South Florida to help reduce HIV/AIDS is now starting to move in both chambers of the Legislature, after passing its first Senate committee Monday.

The measure has been filed for several years, as Sen. Aaron Bean (R-Fernandina Beach) pointed out Monday, during the bill’s first hearing this year in the Senate Health Policy Committee—the panel he chairs.

“If you’re thinking we’ve seen this bill before, we have. It indeed has passed this committee last year—I think for the last two years. Isn’t that correct, Senator Braynon,” asked Bean, during the hearing.

That’s correct,” Sen. Oscar Braynon replied.

The Miami Gardens Democrat is the bill’s Senate sponsor—who’s been working to pass the bill for three years. He says the measure establishing a needle exchange pilot program in Miami-Dade comes with a change. And, no state funds would be needed.

“Yup, there’s been one change that we made last year at the suggestion of the Surgeon General,” Braynon continued. “It was run by Jackson Health System and the Health Department. Now, it will be run by the University of Miami to establish this program. Other than that, it’s the same bill.”

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Weekly Roundup: Temperatures Rising as Budgets Unveiled posted on 3/23/15

by BRANDON LARRABEE | News Service of Florida

Things are getting warmer in Tallahassee -- and while the mercury is rising sharply, the hottest thing in town could soon be the battle over the shape and size of the budget for the coming year.

On Friday, the House and Senate unveiled spending plans for the year beginning July 1 that were similar in some respects and vastly different in others. The most striking area of conflict was the bottom line. An austere House budget would spend $76.2 billion -- less even than the almost $77 billion plan that Gov. Rick Scott proposed.

The Senate, on the other hand, made it rain, unveiling an $80.4 billion budget that would be the largest in state history and would include funding for a quasi-Medicaid expansion and a reconfigured Low Income Pool program. Those responsible for the upper chamber's proposal played down the significance of its size.

"Absent an additional $5 billion in local and federal funding, our proposed budget is approximately the same as the initial budget the Senate passed last year," Senate Appropriations Chairman Tom Lee, R-Brandon, said in a statement accompanying the budget. "This conservative approach preserves the resources necessary to address a crisis in Florida’s hospital network."

There are other differences in the plans -- the Senate's focus on health care comes even as it provides fewer dollars than Scott or the House in per-student funding for public schools. Neither the House nor the Senate would reach Scott's recommendation for school spending under the main formula used to bankroll elementary and secondary education.

Those disputes could lead to a climate change in what has so far been a mundane legislative session -- a change that would make it almost as heated inside the Capitol as April in Tallahassee promises to be outdoors.

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Health Expansion, LIP Program Divide Budget Proposals posted on 3/20/15


caduceusIn a move that creates a $5 billion divide with the House, the Senate released a budget proposal Thursday that banks on expanding health-care coverage for low-income Floridians and extending a critical funding program for hospitals.

The Senate proposal, approved by a key budget panel and touted by President Andy Gardiner, reinforces that health-care funding could be the most-vexing issue facing lawmakers during the rest of this year's legislative session.

Senators included $2.8 billion in the budget proposal to pay for an expansion of health-care coverage that is an outgrowth of the federal Affordable Care Act, better known as Obamacare. House Republican leaders have rejected such proposals during the past two years --- and have shown no willingness to go along with a revised Senate expansion plan this year.

If the expansion ultimately is approved, the federal government would cover the $2.8 billion first-year costs of the plan, which the Senate has dubbed the Florida Health Insurance Affordability Exchange Program, or FHIX.

The Senate budget proposal also includes nearly $2.2 billion for the continuation of the Low Income Pool program, which in recent years has funneled additional money to hospitals and other health providers that serve large numbers of poor and uninsured patients. The program, known as LIP, is scheduled to expire June 30 unless the state can reach agreement with the federal government on an extension. Amid such uncertainty, a House budget proposal released this week did not include the money.

Senate Health and Human Services Appropriations Chairman Rene Garcia, R-Hialeah, said the Senate has put together a revised formula for distributing the LIP money to hospitals. Garcia, whose subcommittee approved the budget proposal Thursday, said he hopes the formula would address concerns raised by the federal government about the program.

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