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Session Week 1 (January 14-17, 2020)
The 2020 Regular Session of the Florida Legislature kicked off Tuesday, January 14th, with memorable remarks by House Speaker Jose R. Oliva. His focus over these 60 days of session remains on fiscal prudence and health care reform. Speaking about the health care industrial complex, Oliva was clear about his concern and intent to pave a path for positive change.
“They receive state dollars, federal dollars and private payer dollars. We also extend them all manner of local tax breaks, and it is not enough!” Oliva said. “It will never be enough. Until we have the courage to empower the patient and loosen the regulations which have allowed their empire-building, it will never be enough.”
With his comments in mind, House lawmakers heard dozens of bills on a variety of topics over the past week – approving several measures in the areas of health care, education, commerce and more that offer the promise of positive impact on Floridians statewide. The following briefs highlight several of those bills.
House Health Care Appropriations Committee votes to break down health care barriers (Rep. Rommel is member of this Committee).
Florida House Health Care Appropriations members approved a bill Wednesday that would free advanced practice registered nurses (APRNs) to help patients to the full extent of their education and training.
Florida has a shortage of health care providers, which means some patients don’t have quick access to the primary care they need. However, there are 32,877 APRNs actively licensed to practice in Florida but can only do so under the supervision of a physician.
These APRNs have graduate degrees – many doctoral – and are trained to diagnose and treat illness and disease. Yet, they are stifled in their ability to help patients. Many experienced APRNs are “supervised” by physicians who never see the APRN’s patients, never review a chart, and never do a patient consultation.
Treatment by an APRN is just as safe as a treatment by a physician. In fact, states that allow independent practice see increases in health care utilization and quality of care, which can lead to improved health outcomes. HB 607 brings Florida in line with 30 other states that already allow APRNs to practice independently.
House Health Quality Subcommittee votes to prevent fraud and abuse
Most Floridians conduct business electronically — it’s instant, efficient and secure. It’s time now for the health care industry to catch up. HB 1103 does just that by eliminating paper prescriptions and moving to an electronic format, which could help combat fraud, medical errors and the opioid crisis. Florida House Health Quality Subcommittee members approved the bill Wednesday to further this effort.
HB 1103 would require all prescriptions to be electronically transmitted by July 1, 2021, with exceptions for written prescriptions when there is a temporary electrical or technological failure that prevents electronic prescribing. Written prescriptions exacerbate the opioid crisis because they can be altered, and prescription pads may be lost or stolen and used illegally. Written prescriptions can also cause medical errors when handwriting is misread.
Many providers already e-prescribe medications. At least 15 other states require e-prescribing in some manner, and federal law will require it for all controlled substances beginning January 1, 2021.
House Health Quality Subcommittee votes to drive down health care costs
Patients should know upfront when a health care professional refers them to an out-of-network health care provider, and physicians should not financially benefit from the referrals they make. Florida House Health Quality Subcommittee members approved a bill Wednesday to build those patient-protection measures into Florida law.
Patients are sometimes shocked to learn that the provider they were referred to is out-of-network and only discover it when it’s too late — when they receive the bill. A growing trend among hospitals is to acquire private health care practice groups, such as a physician practice group or an imaging center. Hospitals may pressure these health care providers to only refer patients to providers affiliated with the hospital.
HB 955 prohibits health care providers from referring patients to any hospital in which they hold an investment interest and requires written notice to the patient of a referral to an out-of-network provider.
House Health Market Reform Subcommittee votes for free-market health care reform (Rep. Rommel is a member of this Subcommittee).
Floridians deserve options when it comes to meeting their health care needs. Florida House Health Market Reform Subcommittee members approved a bill Wednesday that frees up more choices for patients who need specialty care.
HB 6059 removes provisions prohibiting licensure of hospitals that serve specific populations. Florida bans hospitals that specialize in cardiac, orthopedic, surgical or oncology care. That means hospitals can’t specialize and become the premier facility in any of those areas.
HB 6059 removes outdated regulatory barriers that hinder competition. Repealing the ban should increase competition and ultimately lead to more high-quality, cost-effective options for patients.
House Health Market Reform Subcommittee votes to ensure hospital charitable care (Rep. Rommel is a member of this Subcommittee).
Hospitals that qualify for local property tax exemptions should have to prove that they provide an equivalent value to their communities. Florida House Health Market Reform Subcommittee members approved a bill Wednesday that requires hospitals to do so.
Current law grants an exemption from local property taxes for property used predominately for charitable purposes. However, the bar for hospitals to qualify for a charitable property tax exemption is low — they only have to demonstrate nonprofit 501(c)(3) status. HB 919 asks this critical question of nonprofit hospitals: Are you doing enough for the community to earn this tax break?
Under the bill, hospitals are required to demonstrate the value of charitable services by providing IRS filings used to report the value of their charitable care, and they would receive a property tax exemption that is proportional to the value of the charity care they provide. Charitable care covered by some form of government payment will not qualify.
HB 919 holds nonprofit hospitals accountable, ensuring they give back enough to their communities to justify their local property tax exemption.
House Health Market Reform Subcommittee votes to create new health care facility (Rep. Rommel is a member of this Committee).
Florida House Health Market Reform Subcommittee members approved a bill on Wednesday that would give patients more options for post-surgery care. HB 827 creates a new licensure category for recovery care centers (RCCs), facilities for post-operative care.
RCCs are a new kind of facility that will give patients access to more options for post-surgery care. These facilities would be able to keep patients up to 72 hours after a procedure at an ambulatory surgical center, hospital, or after an outpatient medical treatment such as chemotherapy.
The bill requires the Agency for Health Care Administration to implement stringent standards for RCCs to ensure patient safety and quality care, just like any other health care facility licensure category. RCCs must have emergency care and transfer protocols with at least one hospital.
HB 827 makes way for a safe, logical, and more personal recovery option for people who need care after a surgery or treatment, but do not want to stay in a hospital.
House Business & Professions Subcommittee votes to end barriers to entry for workers
Burdensome local licensing requirements act as barriers to job entry for skilled workers, prevents mobility, and increases costs for people who are otherwise qualified to work, especially when licensing requirements vary by city or county.
On Wednesday, members of the House Business & Professions Subcommittee voted to give workers greater opportunities to practice their trade and remove barriers created by the patchwork of local licensing requirements. HB 3 addresses the issue so Floridians can work statewide without paying additional fees, passing unnecessary tests or meeting extra experience or education requirements.
HB 3 preempts occupational licensing to the state and allows professionals to work anywhere in Florida without the burdens that local licensing requirements create. Inconsistent licensing requirements across different cities or counties would be eliminated unless specifically authorized by state law. The bill also specifically prohibits local licensure of certain jobs, including painting and flooring installation.
House PreK-12 Innovation Subcommittee votes to expand charter schools
Public charter schools provide families the opportunity to choose a school that best meets their child’s individual needs. On Wednesday, Florida House Republicans on the PreK-12 Innovation Subcommittee voted to expand access to charter schools as a public education option for Florida’s students.
Currently, only a school district may authorize charter schools in their district. HB 953, Charter Schools, allows state colleges and universities to act as public charter school authorizers, in addition to school districts, to meet regional workforce and educational needs.
Nearly 7 in 10 voters nationwide support school choice, according to a RealClear Opinion Research Survey. By allowing state colleges and universities to act as authorizers, HB 953 provides students with opportunities for acceleration into new and exciting educational workforce areas, helping meet Florida’s growing demand for school choice.
House subcommittee approves Intellectual Diversity in Higher Education bill
State university and college students should feel free to express their viewpoints in a marketplace of diverse ideas. On Wednesday, Florida House lawmakers on the Higher Education Appropriations Subcommittee voted to support this concept by approving HB 613.
HB 613, Higher Education, requires all state universities and colleges to survey students and faculty, and publish a report on the status of intellectual diversity at their institutions. The legislation also revises provisions related to performance funding, among other changes.
A study by UCLA’s Higher Education Research Institute found a dramatic leftward shift in the composition of faculty today with progressives at 60% and conservatives at only 13%. Given this dire lack of political diversity, conservative students may have real fears about expressing their opinions. HB 613 reinforces the protections of the First Amendment by helping expose suppression of diverse speech and opinions at Florida’s higher education institutions.
Local, Federal & Veterans Affairs Subcommittee votes to update public notice rules (Rep. Rommel is the Vice-Chair of this Subcommittee).
Floridians should have simple, easy, and free access to public notices. On Wednesday, the Florida House Local, Federal & Veterans Affairs Subcommittee approved a bill that updates how government entities publish public notices so they can better reach Florida residents with key information and reduce the costs associated with doing so.
HB 7 gives government agencies the option to publish legally required advertisements and notices on a public website if certain conditions are met. Currently, Florida law requires state and local government entities to buy newspaper advertisements to share information with the public regarding important deadlines, events, or code changes. Exceptions exist for counties that do not have a newspaper in the county. This bill updates the outdated legal notice publication requirements to better reflect how most Floridians get their information – online.
Today, the vast majority of Floridians have access to an internet connection via a computer, tablet, or cellphone. With so many people online, modernizing the public notice system will result in more residents being informed about meetings that impact their lives – all while saving public dollars.
Legislation to increase fiscal responsibility in government passes House subcommittee (Rep. Rommel is Vice-Chair of this Subcommittee).
On Wednesday, the Local, Federal & Veterans Affairs Subcommittee passed a measure to ensure that community development districts (CDDs) are held to the same high standard as state government.
CDDs are a type of special-purpose local government that should provide basic urban community services in a cost-effective manner. Currently, a CDD board may authorize bonds by a majority vote of the board. HB 851 increases the number of votes required for a CDD board to authorize bonds from a majority vote to two-thirds vote of the board beginning October 1, 2020.
In state government, any proposed new tax or fee, or an increase to a tax or fee, must be approved by a two-thirds vote of the membership of each chamber of the Florida Legislature. Providing the same vote threshold for CDDs is logical and helps ensure consistency.
Florida House subcommittee votes to bring transparency to public records process
In recent years, some agencies have been in the spotlight for unjustified spending of taxpayer money while attempting to hide how much they spent using public record exemptions for trade secrets. Members of the Oversight, Transparency & Public Management Subcommittee on Thursday approved two bills that hold government agencies accountable by ensuring that public information is not improperly exempted from public disclosure as a trade secret.
HB 799 defines the term “trade secret” and creates a uniform public record exemption that applies to all agencies subject to public records requirements. HB 801 repeals agency-specific public record exemptions for trade secrets, associated processes for designating a trade secret, and most references to trade secrets contained in the definitions for proprietary business information.
The residents of Florida have a right to know where, how, and under what terms their tax dollars are being spent. These bills work together to eliminate the lack of uniformity among government agencies in what information they label “trade secrets” and keep from the public view.
Florida House subcommittee seeks to bring transparency to commercial service airports
Florida is home to 20 commercial service airports, four of which are considered large-hub airports. These airports serve Florida’s visitors and residents, but they also have an annual impact of $144 billion on Florida’s economy. On Wednesday, the Transportation & Infrastructure Subcommittee voted to approve a bill to increase oversight, transparency and accountability of these economic drivers.
HB 915 includes several provisions to enhance transparency and accountability for commercial service airports. Specifically, the bill requires the Auditor General, at least once every five years, to conduct operational and financial audits of the state’s large-hub commercial service airports. It requires the members of the governing bodies of large-hub commercial service airports to submit a more detailed financial disclosure to the Commission on Ethics. Under the bill, each commercial service airport must post certain information about its airport operations online, including meeting notices, agendas, and certain documents it submits to the Federal Aviation Administration.
Among many other accountability measures, HB 915 reiterates the ethics standards for the governing body and employees of commercial service airports and requires annual ethics training. The bill requires each commercial service airport to comply with state procurement laws and public record and open meeting laws, and to annually verify such compliance to the state. Ultimately, the bill holds commercial service airports accountable to all Floridians.
HB 915 protects taxpayers by bringing increased oversight and transparency standards to Florida’s commercial service airports.
Session Week 2 (January 21-24, 2020)
Week 2 of the Regular Session of the Florida Legislature opened Tuesday, January 21st, after state legislators joined the nation on Monday in observing the legacy of Martin Luther King Jr.
On Wednesday, the House of Representatives convened and passed several measures. Among these, the body approved a joint resolution to abolish the Constitution Revision Commission, currently one of five ways to amend the Florida Constitution.
The once-every-20-year commission last met in 2018. It has been scrutinized for the way members were appointed and for bundling unrelated topics into single ballot items. If the Legislature passes the ban, voters will ultimately have the final say on abolishing the Constitution Revision Commission.
In committees, lawmakers approved conservative policies to help Floridians overcome barriers to health care and cut through red tape that prevents skilled people from working, among other issues. The following briefs highlight several of those measures, and more.
House Select Committee on the Integrity of Research Institutions holds initial meeting
When news broke that the Moffitt Cancer Center’s Research may have been compromised by the Chinese government, Speaker Jose Oliva took swift action by appointing a special committee dedicated to investigating the issue. On Tuesday, the House Select Committee on the Integrity of Research Institutions convened for the first time to discuss goals and review evidence.
Under the leadership of Chairman Chris Sprowls, committee members shared that at least two Florida research institutions have been targeted for their research by Chinese-government backed organizations: Moffitt Cancer Center and the University of Florida. As the committee investigates these cases – and any others that arise – the members will be looking for evidence of diversion and theft of intellectual property; sharing of confidential information; and nondisclosure of ties to substantial organizations, including foreign governments.
While other research institutions have been the target of foreign attacks, Sprowls said, this is the first time a state legislature has taken action and responsibility to do what it can to correct problems and prevent future ones. In the coming weeks, the Select Committee will invite members from the Moffitt Cancer Center and University of Florida to testify – answering key questions about their internal procedures, how they failed, and why they failed.
House Health Quality Subcommittee votes to make medical records more accessible
The Florida House Health Quality Subcommittee approved a bill Tuesday to ensure that Floridians gain access to their medical records in a standardized, timely manner. HB 1147 sets the timeframe that health care providers and facilities must produce or allow inspection of records and empowers patients to control their records in the form most convenient for them.
Requesting medical records should be a straightforward process; however, it is often inconsistent, confusing, and subject to repeated delays. HB 1147 ensures that, regardless of provider type, each practitioner and facility must produce all requested records in their possession within 14 working days and allow inspection of all records in their possession within 10 working days. Furthermore, providers and facilities must produce the records in the form the patient selects.
A patient will receive treatment from many health care providers throughout their life, and each provider will create and maintain a record of that treatment. It is crucial that the patient and each of his or her current and future providers have prior treatment records for the patient to receive the best care.
House Health Market Reform Subcommittee votes to end surprise medical billing (Rep. Rommel is a member of this subcommittee).
This week the Florida House Health Market Reform Subcommittee approved a bill that protects Floridians from surprise medical billing.
Costs associated with health care services and procedures have the potential to result in significant medical debt for patients, and even bankruptcy. Even if medical costs do not result in bankruptcy, they can weigh heavily on patients. Past legislative efforts have helped patients get more information on health care costs prior to care, but more needs to be done to empower patients and protect them from unfair billing practices.
HB 959 empowers and protects patients by requiring health care facilities to provide good-faith estimates of charges for non-emergency medical services to patients and prohibiting facilities from charging any more than the estimate plus 10% — except if in unforeseen circumstances. The bill also increases medical debt collection consumer protections.
Current law requires all hospitals, ambulatory surgical centers, and urgent care centers to provide each patient an estimate of charges prior to providing any non-emergency medical services – but only upon patient request. HB 959 makes these estimates mandatory and binding unless unforeseen circumstances or additional services result in the need for additional charges. If so, those charges must be explained in writing.
HB 959 increases certainty regarding the costs of recommended treatments and medical procedures, and protects patients from unfair billing practices.
House Health Market Reform Subcommittee votes for open, transparent access to health care information (Rep. Rommel is a member of this subcommittee).
Health care providers have some flexibility in discussing costs with patients, but there may be cases when a provider’s contract with an insurer limits communication related to costs of care. Florida House Health Market Reform Subcommittee members approved a bill Tuesday to ensure open communication.
HB 1205 prohibits a health insurer or Health Maintenance Organization (HMO) from limiting the ability of any provider to discuss pricing information with a patient, ensures that insured patients do not pay more than an uninsured patient for a health care service, and safeguards a patient’s right to open communication with providers regarding costs of care.
As health care costs continue to rise, many health insurers are asking consumers to take on a greater share of their costs by increasing premiums and out-of-pocket expenses. Patients should have the information they need to be able to choose less expensive health care services – or even pay for a service themselves, rather than using insurance, if it’s less expensive.
House Local, Federal & Veterans Affairs Subcommittee votes to improve government transparency (Rep. Rommel is Vice-Chair of this Subcommittee).
Members of the Florida House Local, Federal & Veterans Subcommittee approved a bill Tuesday to ensure that local governments are responsible and transparent stewards of taxpayer dollars.
HB 1149 helps residents gain access to important information, including voting records related to tax increases and the issuance of tax-supported debt. The bill also enhances access to tax history and property tax information, expands public meetings and notice requirements, and requires local governments to conduct and consider a debt affordability analysis before approving the issuance of new long-term, tax-supported debt.
Under current law, most local governments are required to have an annual financial audit. HB 1149 requires the auditor to report whether the local government is in compliance with the provisions of the new act created by the bill. Local governments not in compliance must provide evidence that corrective action has been initiated within 45 days and completed within 180 days.
HB 1149 ensures that Floridians have open, easy access to the information they need to be more engaged with their local government.
Florida House subcommittee seeks to bring transparency to commercial service airports
Florida is home to 20 commercial service airports, four of which are considered large-hub. These airports serve Florida’s visitors and residents, but they also have an annual impact of $144 billion on Florida’s economy. On Wednesday, the Transportation & Tourism Appropriations Subcommittee voted to approve a bill to increase oversight, transparency, and accountability of these economic drivers.
HB 915 includes several provisions to enhance transparency and accountability for commercial service airports. Specifically, the bill requires the Auditor General, at least once every five years, to conduct operational and financial audits of the state’s large-hub commercial service airports. It requires the members of the governing bodies of large-hub commercial service airports to submit a more detailed financial disclosure to the Commission on Ethics. Under the bill, each commercial service airport must post certain information about its airport operations online, including meeting notices, agendas, and certain documents it submits to the Federal Aviation Administration.
Among many other accountability measures, HB 915 codifies the ethics standards for the governing body and employees of commercial service airports and requires annual ethics training. The bill requires each commercial service airport to comply with state procurement laws and public record and open meeting laws and to annually verify such compliance to the state. Ultimately, the bill holds commercial service airports accountable to all Floridians.
Florida House subcommittee votes to protect public employees
On Wednesday, the Oversight, Transparency & Public Management Subcommittee voted on legislation to tighten the regulation and oversight of unions.
HB 1 requires a public employee who desires to join a union sign a membership authorization form that says Florida is a right to work state and union membership is not required as a condition of employment. The authorization form must also provide that membership and payment of dues and assessments is voluntary. Among other protections, HB 1 prohibits unions and employers from asking an employee to provide a reason for leaving the union.
The bill makes clear any dues and uniform assessments may not be deducted from an employee’s salary until the employer receives signed authorization from the bargaining agent and confirms with the employee that he or she, in fact, authorized it. Authorization for dues deductions must be reauthorized annually.
House Committee votes to expand Sunrise Review process for regulated industries
When excessive regulation goes unchecked, working Floridians and small businesses suffer. This week, the House Business & Professions Subcommittee passed HB 1155, which strengthens Florida’s Sunrise Act in order to ensure that proposed regulations of professions are necessary to the protect the public’s health, safety, and welfare.
Florida’s Sunrise Act requires a formal review of proposed regulations of professions that includes a cost-benefit analysis. Currently, it only applies to legislation that proposes regulation of an unregulated profession. HB 1155 expands the scope of the Sunrise Act by requiring a formal review for legislation that expands the scope of a regulated profession to include currently unregulated activities.
This bill helps ensure that Florida residents, businesses, and industries can thrive in a healthy regulatory environment that promotes the free market.
Florida House Committee passes Occupational Freedom and Opportunity Act
Excessive regulations can hinder economic growth and act as barriers to workforce entry for many Floridians who are trying to make a living. This week, the House Business & Professions Subcommittee passed HB 1193 to free workers from redundant licensure and training requirements.
For barbers and cosmetology specialists, HB 1193 reduces the excessive hours of training required to obtain a license to work. For occupations where a license is simply unnecessary, such as commercial interior designers and hair braiders, HB 1193 would eliminate the state licensing requirement. The bill also expands license reciprocity measures for several professions.
Many of the deregulated professions in the bill already have industry standards in place, so continuing to require a license for those professions beyond what preserves the public health, safety, and welfare is unnecessary.
Public Integrity & Ethics Committee approves ethics reform package
Public servants should be intentional about ethics and careful to avoid any inappropriate personal benefit from their role or status. To that end, the House Public Integrity & Ethics Committee on Thursday approved a bill to help strengthen rules for ethical behavior in government.
To this end, HB 1185 would help weed out conflicts of interest by banning some actions and requiring that public servants report new information. Among many reforms included in the bill, statewide elected officials are prohibited from taking a job offered as a result of their official duties or political status. Additionally, state workers cannot seek a job at an organization regulated by their employer agency, and statewide elected officials must report salary increases or new posts if they work for an organization that receives state dollars.
HB 1185 advances the Florida House of Representative’s commitment to eliminating corruption, fraud, and abuse in government.
Public Integrity & Ethics Committee votes to keep government accountable
Floridians deserve governments that are transparent and accountable to them and held to the highest ethical standards. The House Public Integrity & Ethics Committee on Thursday approved a bill to advance this idea.
HB 1111 promotes integrity in government by identifying and eliminating government waste, fraud, abuse, mismanagement, and misconduct. Among many reforms, the bill creates a “Florida Integrity Office” with the sole purpose of ensuring accountability among state and local governments. The state’s chief financial officer would be responsible for sending suggestions from Florida’s “Get Lean” hotline to the new Integrity office for review. HB 1111 also helps motivate state employees to report cases of misconduct or abuse in government by authorizing financial incentives.
Floridians are better served when their state and local governments are committed to being transparent and accountable to taxpayers.
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