FAFP Committee Week Update

February 9, 2007

 

 

            The Legislature completed a short committee week and headed home Thursday afternoon.  The House returns next week to work on its budget, the Senate is off.  This week hundreds of bills were filed as legislators try to meet the pre-session bill filing deadlines. We are currently tracking over 100 bills of interest to FAFP.  [Despite the large number of bills filled, the committees continued to hear agency presentations this week with very few bills being heard.]  Following is a brief summary of some key issues confronting your association and your patients:

 

Immunizations

 

            FAFP is joining with the FMA and others to oppose HB 543 by Representative Zapata.  The bill allows pharmacists to administer all type of immunizations, not just flu shots.  These include diphtheria, hepatitis B, measles, mumps, pertussis, polio, rubella, tetanus, pneumococcal meningitis, and many others.  Currently no Senate bill has been filed, but we expect to see something filed in the next few days.

 

Other Scope Bills

 

            Senator Saunders again filed a bill to allow ARNPs to prescribe controlled substances (SB 553).  As in years past, FAFP will oppose this legislation.  We are awaiting a House companion bill.

 

            Senator Margolis filed SB 1300 that allows a psychologist to order lab tests.

 

HPV Screening

 

            There is legislation filed (SB 660/HB 561) this year that requires public and private middle schools in the state to provide information to students who are 11 and 12 years of age and their parents concerning the human papillomavirus (HPV), its vaccine, and cervical cancer.  It would prohibit those students from being admitted into school without evidence of vaccination for HPV.  The bill does provide for an exception if the parents, after receiving information, sign a waiver to allow the child to attend the school.

 

There has been much media attention spent on this bill here in Florida as well as in other states, such as Texas, because of the controversial nature of this disease, its potential social implications and that currently only one company makes this vaccine.  Texas’s Governor Rick Perry issued an executive order requiring the vaccine without a parent’s permission.  In Florida, the sponsors of this year’s bill are firm in requiring parental consent for this procedure. Payment for the vaccine would be provided through a variety of sources including Medicaid, private insurers (if the family has insurance) and county health departments would cover the cost for those families who aren’t eligible for Medicaid but don’t have insurance coverage.  The estimate for that portion for the vaccine’s cost is said to be $16 million.

 

Neither bill has been heard by a substantive committee as of this report.

 

The Uninsured

 

            The House Committee on Health Innovation received a presentation on the Uninsured in Florida by R. Paul Duncan, Ph.D. from the Department of Health Services Research, Management & Policy at the University of Florida.

 

His research shows that there were approximately 46.5 million uninsured in the United States in 2006 as compared to 34.4 million in 1990. In Florida, there were 2.7 million or 19.2% uninsured in 2004 as compared to 2.1 million or 16.8% in 1999.The number is on the rise throughout the country, especially in our state.

 

Florida ranks 6^th in the nation for the most residents who are uninsured. Out of Florida’s 67 counties, Miami-Dade has the highest rate of uninsured residents. Adults rank as the highest category of uninsured, followed by seniors age 65 and up, and then children. The research indicates that roughly 20% of Floridians opt out of insurance coverage because of the following reasons:

 

·         Coverage is not offered by their employer and they can’t afford the it;

 

·         Coverage is not paid in full by their employer and they can’t afford to pay the remainder; or

 

·         A person has a clean bill of health and does not desire to pay for insurance coverage.

 

Health insurance costs have also been on the rise and typical family coverage (not necessarily the premium coverage) is approximately $12,000 per year. Dr. Duncan listed several policy options during the presentation that might help to increase the number of insured residents in the State. The options included:

 

·         Lower costs by market pressure (Consumer Directed Health Care) or by Changing the Content of Benefits (prevention, prescription coverage)

 

·         Increase Private Coverage (incentives for employers; incentives for employees; tax credits for those purchasing individual coverage; mandates; scaling back the content of coverage to lower costs)

 

·         Increase Public Coverage (Medicare expansion down to age 55; Medicaid expansion

 

 

 

The Budget

 

Legislative committees were briefed on Governor Crist’s budget from various agencies this week.  His proposed budget of $71.5 billion dollars is actually less than the current year’s spending.  Contributing factors to this budget reduction are reduced levels of documentary doc stamp revenue, a smaller transportation work plan and the fact that a bailout of Citizens Insurance ($1.2billion this past year) is not necessary this year.

 

Overall, the health and human services budget does increase by 3.1%.   The largest increase among the health care related agencies is 13.2% for the Agency for Persons with Disabilities.  The reason for this spike is the agency underestimated its budget needs for this year and will have to make up for those underestimated recipient numbers.  Gov. Crist proposes to increase the Department of Health’s budget by 7.8% and the Agency for Health Care Administration by 2.1%.  A key factor holding down health care spending is the reduced number of expected Medicaid recipients.  As of February 9, the Social Services estimating conference expects Florida to serve just over 2 million residents, but that is more than 137,000 less than the current year.

 

Other Happenings   

 

Next week Dr. Oslos and Dr. Prevatte are meeting with Senator Evelyn Lynn to discuss increased funding for Residency programs.  Also, Dr. Strong is meeting with Dr. Andrew Agwunobi, the new Secretary of the Agency for Health Care Administration to discuss physician reimbursement and other Medicaid issues