Session results in minimal funding reduction, reduced paperwork for nursing homes

The 2012 session ended March 9 with nursing homes spared from significant funding cuts when the Legislature passed the 2012-13 Florida state budget. The final budget (HB 5001) reduced the originally-proposed 2.5 percent ($76 million) Medicaid funding cut to nursing home care to a lower cut of 1.25 percent ($35.2 million) and reflects full funding of price level increases (inflation). Additionally, the budget expands the Nursing Home Quality Assessment, which allows for some “buyback” of previous Medicaid reductions. “The stories that were shared by the hundreds of long term care professionals this session of how facilities have had to cope with cuts to Medicaid and Medicare over the past six months made a difference. We’re pleased that legislators recognized those challenges and were able to minimize the impact on nursing homes when the final budget passed,” said Emmett Reed, Executive Director of the Florida Health Care Association.

FHCA has always been proactive in offering suggestions to legislators that would help the state with its growing Medicaid budget. A member-driven priority for FHCA this session was the concept of allowing life insurance policies to be used for payment of long term care services. FHCA commissioned Florida State University's Center for Economic Forecasting and Analysis to examine the use of life insurance policy assets as a means of private funding in order to pay for long-term health care needs. The study found that annually there are approximately 4,272 to 4,486 residents with the potential to convert their life insurance policies into long-term health care benefit plans. According to the study, that would represent a net savings to the state's total Medicaid budget of approximately $138.3 - $157.4 million.

This concept was the premise behind SB 1756 by Sen. Joe Negron (R-28) and HB 1055 by Rep. Rachel Burgin (R-56), which received positive feedback in both chambers this session. However, given that it involves two very complicated issues – Medicaid eligibility and insurance – Rep. Burgin recommended that further study on this issue be conducted.

FHCA is pleased to report that the budget also included proviso language to establish a technical advisory workgroup to examine methods to allow an insured under a life insurance policy or the contract holder of an annuity, to convert the policy or annuity to a long term care benefit. The workgroup will include, but is not limited to, representatives from nursing home providers, life insurance companies, and life insurance agents. FHCA will keep members apprised of the outcomes of the workgroup, which will be important to helping address any technical issues before legislation is reintroduced next session.

Nursing homes will also see relief from duplicative requirements with a number of FHCA-supported regulatory changes that were passed as part HB 787 by Rep. Carlos Trujillo (R-116). These changes will have a positive impact on residents, as caregivers will have more time to focus on care rather than duplicative paperwork requirements. Provisions in HB 787 include: elimination of the 24-hour Adverse Incident report and the quarterly staffing report; clarification of eviction and nursing home discharge laws; implementation of requirements to allow nursing homes to provide respite care; placement of pediatric staffing standards into statute; allowance of home-office audited financial records in the CON process; and care plan and medical records revisions, as well as other regulatory fixes.

Although the Legislature was unable to reach an agreement on assisted living facility reforms this year, FHCA was able to educate lawmakers about the differences between nursing homes and assisted living facilities, with a particular emphasis on the negative impacts that electronic monitoring devices ("granny cams") have on resident privacy.

FHCA is extremely grateful to all of those who joined us in advocating for our long term care priorities both before and during the 2012 legislative session. No doubt the outcomes of this session resulted from a combined effort by FHCA members and staff in fostering legislator relationships, building a strong and comprehensive strategy and taking a proactive and unified approach to convey our key messages. FHCA members can read a more thorough wrap-up report of the 2012 legislative session by clicking here.

Final Countdown of 2012 Session with FHCA Legislative Team

FHCA Executive Director Emmett Reed interviews members of FHCA's legislative team direct from the Florida Capitol in the final hours of the 2012 session. Also interviewed are Rep. Jim Frishe (R-54) and Rep. Will Weatherford (R-61).

Background Screening Bill Passes, Heads to Governor's Desk

FHCA is pleased to report another successful legislative outcome. HB 943 by Rep. Doug Holder (R-70), which makes several fixes to the background screening law enacted in 2010, has passed and is on its way to the Governor's desk for signature. FHCA has taken an active role on this issue, providing initial recommendations to the Governor's Interagency Background Screening Workgroup in December and supporting important legislative amendments to address several fixes as the bill made its way through the process.

HB 943 will fix the "volunteer" issue that caused Gov. Scott's veto last year, as well as the redundant background screening issue that affects DOEA direct-service providers and many of FHCA's ALF members. The bill also allows employers to hire a person for training and orientation prior to having a screening complete with certain caveats, and reduces duplicative screenings for CNAs. It also clears the way for sharing background screening information across agencies through the Agency for Health Care Administration’s new clearinghouse and sets up a new requirement for employers to report employment status changes to the clearinghouse. LiveScan fingerprint vendors will now be asked to meet certain practice thresholds and will be approved by FDLE.

FHCA wants to thank all those members who spoke to legislators throughout the session to encourage their support of this bill. The bill becomes law upon signature by the Governor, and we will keep you updated once that happens.

Important Amendment Fixes Prescribing Controlled Substances Issue

FHCA is pleased to report that, this morning on the Senate floor, Senator Ellyn Bogdanoff (R-25) amended HB 1175 to include language that will fix a serious problem being experienced by physicians prescribing controlled substances to residents in nursing homes. FHCA had previously reported that these problems were resulting from the "pill mill" legislation that passed last year.

The amendment modifies 456.44, Florida Statutes, to state that the subsection "does not apply to a physician who treats a patient who is admitted in a nursing home or related health care facility or receiving hospice services as defined in chapter 400."

This is a great victory for FHCA, and we want to thank all of those who have worked so hard for this important issue, including our FHCA members along with representatives of the Florida Medical Directors Association. The bill now goes back to the House for a floor vote, and we will keep you informed of its progress.

Nursing Home Budget Update

Last night, House and Senate budget negotiators came to an agreement on issues contained in the Health and Human Services budget, including funding for nursing home care. Budget conferees have agreed to meet in the middle on the funding cut, meaning the House's originally proposed 2.5 percent has been reduced to 1.25 percent (approximately $35 million). As previously reported, both chambers’ budgets had fully funded price level increases (inflationary increases), and that has not changed.

Barring any major holdups, the 2012-13 budget is expected to be finalized by late this evening to allow for the three-day cooling off period before the vote is taken on Friday and the 2012 Legislature can sine die. And while we have not quite reached the finish line, FHCA is extremely grateful to its members for their ongoing support both before and during this year’s session. Time and again, our members rose to the call and the voices of long term care were heard. Over 500 long term care professionals took part in FHCA's Lobby Wednesdays this session, sharing stories with lawmakers that resonated, as was made evident by the budget outcome.

As we enter this final week of the 2012 session, FHCA will continue to advocate for the remaining legislative issues that impact the long term care profession. Stay tuned for updates on the progress of the bills we're tracking.

FHCA Provider Program - 2012 Lobby Wednesdays a Wrap

FHCA welcomes its final group of members in town for Lobby Wednesday, including representatives from Airamid Health Management and Summit Care. Also, Executive Director Emmett Reed discusses conferencing on the budget and progress of the bills we're tracking.