Meeting Legislative Candidates

It's hard to believe that legislative candidates for the 2010 fall election are already out in the community meeting voters and raising money for campaigns. But regardless of what you might say about how early it seems, FHCA has been right in the thick of it, educating some of these early birds on our important long term care issues.

On Wednesday, June 24, Senator Jack Latvala, who is running for Senate District 16 (he previously represented a nearby area) visited Palm Garden of Clearwater and Administrator Roy Meredith and his staff provided a tour followed by sandwiches and sweets. Great job!

That evening we headed to Bradenton to the home of Senator Mike Bennett (R-21), where we joined FHCA Executive Director Emmett Reed and FHCA Vice President Nina Willingham at a fundraiser for Greg Steube (R), candidate for House District 67. Warm breezes off the Gulf and good food and drink enabled everyone to relax and meet the candidate, who is an Iraq war veteran and the son of the local sheriff. We look forward to having Greg visit some local nursing homes in the near future.

We encourage our FHCA members to invite their local legislators and 2010 candidates into your building to help educate them about the valuable work you do in caring for Florida's nursing home residents. First-hand visits are a great way to help them learn more about our long term care issues and help your residents and staff meet the lawmakers who impact their lives. You can visit the Members Only Legislative Section on the FHCA Web site for tips on how to conduct a successful legislative visit, and be sure to e-mail me an update and photos so we can share it with the rest of the membership.

FHCA Testifies Before US Aging Committee, Urges Importance of Coordination Between Policymakers & Long Term Care Providers In Planning for Disasters

On Wednesday, the Florida Health Care Association’s (FHCA) Senior Vice President of Policy and lead emergency preparedness representative, LuMarie Polivka-West, testified before Congress, focusing on the importance of a coordinated effort between long term care facilities and the government in all aspects of disaster planning and preparedness [to view the complete testimony, click here].

“The Florida Health Care Association has been taking the lead in Florida in ensuring that our state’s frail elders and citizens with disabilities residing in nursing homes and assisted living facilities are able to retain access to the long term care and services essential to their health and well being during a disaster,” stated J. Emmett Reed, FHCA Executive Director. “We encourage Congress to take swift action to ensure that all care providers – regardless of tax status – can access federal assistance for disaster relief efforts.”

In her testimony before the Senate Special Committee on Aging, Polivka- West discussed complications that occurred during the 2005 hurricane season, stating, “As decisions were being made regarding evacuations, many nursing home administrators did not have the same knowledge or guidance about when and if they should evacuate as hospitals did. Following several hurricanes during that season, utility services did not understand the special needs of the frail elderly and those with disabilities in nursing homes and assisted living communities, leaving them without electricity and telephone services.”

As the Senior Vice President with the Florida Health Care Association (FHCA) and Principal Investigator of the John A. Hartford Foundation Emergency Preparedness grant, Polivka-West discussed the steps that need to be taken by our nation’s long term care facilities and policymakers to develop appropriate disaster planning. These steps include creating a disaster planning guide and software that facilities can refer to, including disaster preparation training exercises in nursing home staff program, and assembling annual hurricane summits.

Polivka-West addressed the importance of keeping facilities informed and supplying them with the tools to be prepared in any given emergency situation. She stressed that forming a constructive dialogue with legislation is crucial to creating a well-executed disaster plan. “Due to the very vulnerable and complex population that we serve it is essential that we work together with policy makers to better prepare ourselves for any disaster,” stated Ms. Polivka-West.

“The road ahead is no doubt challenging,” concluded Polivka-West. “But the important task before us is to objectively examine how local, state, and federal governments – working with transportation, the health care spectrum and business groups – can better prepare for and coordinate disaster recovery efforts for our most vulnerable citizens nationwide.”

FHCA partners with its national affiliate, the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), to make available emergency preparedness resources and information to other long term care facilities across the country. Polivka-West serves as a member of the AHCA/NCAL Disaster Preparedness Committee. FHCA has worked in concert with AHCA/NCAL in coordinating a number of national summits, including the most recent one in December 2008 which brought together state and federal partners in long term care, transportation and emergency management to examine the availability of and access to transportation resources for long term care providers during emergency situations.

2009 Legislative Session Outcomes for Nursing Homes

When legislators cast the final vote on Friday, May 8, nursing homes saw a three-percent cut to their Medicaid rate; however, the Nursing Home Quality Assessment Program will be adjusted to for providers to "offset" the cut through an expanded assessment, thus allowing the state to draw down additional federal dollars to fund nursing home care.

Additionally, there will be no permanent elimination of the annual price level increase in the nursing home budget. Facilities’ financial stability will be preserved, as well as their ability to effectively recruit and retain qualified staff and cover their increasing costs of fuel, utilities and property/casualty insurance. Legislators also agreed to allow a one-year waiver of the lease bond requirements, which takes effect July 1, 2009.

Also taking effect July 1st is the restoration of the 2.9 CNA staffing level contained in the statute. The provision allowing nursing homes to “buy back” their rate cuts will ensure the funding is available to pay for the staffing that is resulting in dramatic improvements to nursing home quality care.

The collective efforts of FHCA members, staff and lobby team resulted in this year's successful outcomes, at a time when many other areas saw significant funding cuts. The impact of the hundreds of nursing home owners, administrators, caregivers and family members descending on the Capitol during Lobby Wednesdays, as well as the thousands of e-mails sent to legislators urging them to protect funding for nursing home residents did not go unnoticed. FHCA is thankful to all who helped make a difference during the 2009 session to preserve quality care for our state’s frail elders.

Session Extended for One Week

Today we learned the session has been extended for one week, through May 8, to deal with budget issues only. House Speaker Larry Cretul and Senate President Jeff Atwater announced earlier that the framework for the budget has been worked out, which means conference committees can begin meeting this afternoon, with discussions expected to continue through Friday. The schedule has budget chairs meeting through the weekend, with the budget printing on Monday and being submitted to legislators by Tuesday. After the required 72-hour cooling-off period, a final vote on an agreed-upon budget is expected by next Friday, May 8.

As the End Draws Near...Or Does It?

As we plan for what we hope will be the last week of the 2009 legislative session, we are all waiting to see whether or not the budget is finished by Tuesday. If not, legislators will have to either extend the session, or go home and come back, before the June 20, 2009 expiration of the current budget. Unfortunately, taxpayers pay the price if session is extended or a special session is convened at a cost of $40,000 per day.

Meanwhile, a limited number bills are moving in either chamber. As we've been reporting, a health care train that contains the Agency for Health Care Administration's regulatory bill along with a Medicaid fraud bill now includes language on a new way to provide home care through the state's medical schools. Could this be another attempt at Medicaid reform? Last week, the nursing home therapeutic formulary bill we've been monitoring was amended to include so many requirements that it has been removed from the pharmacy bill. In other news, the controversial election bills may be dead for the time being, but we've seen oil drilling pop up as a last minute issue, so it will be interesting to watch that debate.

It seems as if the drive to reduce regulation and streamline governmental operations this session has lost its momentum. One wonders if the overriding pressure from the state budget is causing this low number of bills to pass this session. In any event, FHCA will continue tracking those health care bills on which we've been reporting in these last nine weeks, as well as keeping an eye on whatever outcome results as the clock ticks away on lawmakers' timetable to pass a budget in the final days.

Midweek Update

As we reach the last 10 days of the 2009 session (we hope!) we are seeing the creation of some health care trains, a concept that has been somewhat obsolete for a few years but is now coming back. This typically happens when bills are stuck in committees and legislators, worried they will run out of time before the end of the session, will add on an amendment to a bill that appears to be moving through the process. On Monday, Rep. Homan's bill, HB 7131, which deals with medical encounter data, was amended to include the text from HB 651 by Rep. Hudson, which is the Agency for Health Care Administration's deregulation bill, and SB 1986 by Senator Gaetz, which is the Medicaid fraud bill. There is no Senate companion to HB 7131, which is a requirement for a bill to be passed, so we'll be watching the bill carefully to see how things will progress.


The nursing home therapeutic formulary bill, SB 1868, will be debated on the Senate floor on Thursday. FHCA is continuing its communication with all Senators to help them understand how important this issue is to long term care providers.



FHCA also continues to work on an amendment to ensure that nursing home residents have access to voting at the polls. As we mentioned previously, an elections bill has, in fact, been passed by the Senate, SB 956, and by the House, HB 7149, but will need much work if it is going to pass the full bodies on the floor.