Tuesday, May 28, 2013

Governor Signs 2013-14 Florida Budget

Impact on Long Term Health Care Programs At A Glance

Last week, Governor Rick Scott signed the 2013-2014 Florida Budget, reducing it down from $74.5 billion to $74.1 billion as a result of $368 million in line item vetoes. The budget provides $3.01 billion for nursing home care, which, as indicated, reflects full funding of workload and price level increases (inflation). The budget continues the Special Medicaid Payment Program for government-funded nursing homes ($11 million) and eliminates the rate add-on for HIV/AIDS ($4.1 million).

Additionally, the budget increases the nursing home quality assessment by approximately $18 million, to a total of $430.2 million, and increases the rate from $22.89 to approximately $23.87 per non-Medicare patient day. The quality assessment provides for rate "buyback" of approximately $585 million, compared to $540 million in the current year. This is an approximate $45 million increase in the amount of prior year rate reductions to be restored.

Programs vetoed that were related to long term health care for elders included the Supplemental Payment for Nursing Home Ventilators ($2,511,493); Rate Increase for Private Duty Nursing Services Provided by Licensed Practical Nurses ($9,384,984); Alzheimer's Community Care Association ($300,000); Northdale Civic Association - Senior Center ($50,000); Southwest Social Services - Badia Senior Center ($1,000,000) and the Program of All-Inclusive Care for the Elderly (PACE) in Lee, Hillsborough and Broward Counties ($4,353,039).

Wednesday, May 8, 2013

FHCA Post-Session Report

The 2013 legislative session officially ended Friday, May 3, with the Legislature passing 286 bills, including the $74.5 billion budget for 2013-2014. The budget includes pay raises for teachers and state workers, along with a 3 percent tuition hike for college and university students. It also expands early voting days and the number of sites where early voting can be held and sets aside money for small and large projects, including $70 million to help restore the Everglades.

The budget does not include any federal aid to cover additional people under Medicaid, a key component of the Affordable Care Act. The Legislature's failure to reach a compromise over Medicaid expansion resulted in an intense political battle during the final days of session, and speculation over whether lawmakers will return to Tallahassee this summer for a special session has already begun.

The amount of time and energy lawmakers spent on this issue took its toll on FHCA's key priorities and health care, in general, as very few health-care related bills were passed by the 2013 Legislature.

For the first time since 2007, the 2013 Legislature was in the unique position of having a budget surplus rather than facing a budget deficit. Given that, FHCA made restoring previous funding cuts to nursing home care one its key legislative priorities for the session.

In January, Governor Rick Scott released his initial budget. In addition to calling for higher teacher pay and manufacturing equipment sales tax cuts, the Governor's budget fully funded the estimated 2013-2014 expenditures for nursing homes, including full inflation (estimated to approximate 2 percent).

The initial budget released by the Senate in March also called for the full funding of nursing homes as provided under current law, including the expected inflationary increase. The House, however, released its initial proposed budget which kept rates at their current levels and eliminated the projected 2.0 percent inflationary increase, reducing funding for nursing home care by $45.6 million.

In the end, the collective work of FHCA staff, its lobby team and the membership paid off, as the initial House offer during the Conference process moved to the Senate position of fully funding estimated nursing home expenditures, including inflation.

As one of the final acts of session, the Legislature passed the Villages CON bill (HB 1159), which is now on its way to the Governor for signature. The bill was amended to replace the original language, which eliminated the CON laws within the Villages and several other deed-restricted communities in Florida, with a competitive expedited review process for nursing homes. Several other health care items, not related to nursing homes, were added to the bill prior to final passage.

Several long term care issues were stifled by the Legislature’s intense focus on Medicaid expansion. Those issues left unfinished included ALF reform; regulation of pediatric nursing facilities; the use of life insurance policies for long term care services; and language to exempt nursing homes from the pain clinic regulations. FHCA expects those issues to re-emerge in the 2014 session.

With the 2013 legislative session now over, FHCA would like to thank the membership for supporting the Association in our efforts to advocate on behalf of the providers committed to delivering high-quality care to our state's frail elders every day. The tremendous support from our volunteer leaders, member involvement in our grassroots initiatives and the tireless efforts of the Association staff together led to a positive budget outcome for Florida's nursing homes. FHCA would also like to thank our associate members who took an active role in this year's legislative activities, including PharmScript, who sponsored Lobby Wednesdays, and Bouchard Insurance, who sponsored FHCA's Provider Program.

For a comprehensive look at the issues that impacted long term care this session, click here to access FHCA's 2013 Legislative Session Wrap Up.

Friday, May 3, 2013

FHCA Provider Program - 2013 Legislative Session Draws to a Close

The final week of the 2013 legislative session draws to a close. FHCA's Government Affairs team reflects on the budget, the issues worked by the Association and the important role members played in our grassroots initiatives.