The Florida Legislature passed a record-setting $112 billion budget to conclude this year’s legislative session, bolstered by $3.5 billion in federal stimulus money and unexpectedly high tax collections. However, Governor Ron DeSantis has the power of a line-item budget veto and has warned he would be making some changes, confirming that there will be vetoes in the budget.
Typically 60 days long, this year’s session went into overtime after lawmakers couldn’t finish their budget negotiations to meet the state’s mandatory 72-hour “cooling-off” period. As a result, adjournment ”sine die” took place on March 14.
Lawmakers also passed 285 bills, including new redistricting maps. Issues left unaddressed included reforms to Florida’s increasingly rising home insurance market and condo regulation in the wake of the collapse of Champlain Towers South in Surfside last June.
Here is a recap of several of the significant issues addressed during the 2022 Florida legislative session:
More Equitable Medicaid Funding
Over 200 Florida hospitals will finally see greater state funding parity for vital Medicaid and charity care services. The approved budget eliminates a $300 million “automatic rate enhancement” fund previously provided to only 28 hospitals. Originally intended as a short-term stopgap solution for a one-year loss of federal funding, the hospitals that most benefited from the money successfully lobbied to renew it each year from 2016 to 2021.
Lawmakers extended COVID-19 legal protections for hospitals, nursing homes, and other healthcare providers to June 1, 2023. The legislation builds on protections enacted last year to prevent lawsuits for liability related to “damages, injury, or death.”
Pandemic rules will be relaxed under a bill that creates a uniform set of visitation rights for family members at hospitals and medical facilities. The legislation sets out policies and procedures on infection control screening, personal protective equipment, permissible length of visits, and number of allowable visitors. Residents, clients, and patients can designate an “essential caregiver” who is entitled to two hours of in-person visitation per day. Facilities cannot require proof of any vaccination for a visit.
Directed Payment Program
Legislators approved the Directed Payment Program (DPP), a supplemental payment program for hospitals that will help to bridge the gap between Medicaid reimbursement rates and their actual cost of providing Medicaid care. DPP is funded through local dollars used to draw down federal Medicaid dollars.
HCA Healthcare sponsored SB 1374 to help address a statewide shortage of medical professionals. It allows RNs to perform moderately complex lab tests within a hospital or off-site emergency department. The bill, which lawmakers passed shortly before the end of the legislative session, also exempts nurses from taking lab tech certification exams under the Board of Clinical Laboratory Personnel.
To address the critical nursing shortage in Florida, SB 2524 provides funding to create the LINE and PIPELINE programs. $6 million was allocated to establish the Linking Industry to Nursing Education (LINE) Fund, a competitive grant program that provides matching funds, on a dollar-to-dollar basis, to participating institutions that partner with a healthcare provider to recruit faculty and clinical preceptors, increase capacity of high-quality nursing education programs, and increase the number of nursing education program graduates who are prepared to enter the workforce. $40 million was allocated to establish the Prepping Institutions, Programs, Employers, and Learners through Incentives for Nursing Education (PIPELINE) Fund to reward school districts, Florida College System (FCS) institutions, and State University System (SUS) institutions that meet nursing education program performance metrics.
The state budget also includes $1 billion to raise the minimum wage for all healthcare provider employees to $15 per hour, and $6.4 million in increased GME funding for HCA Healthcare.
Medicaid Managed Care
With over five million Floridians now enrolled in a Medicaid plan, the state is responding with substantial changes to its Medicaid Managed Care program. Beginning in 2025, AHCA will reduce the number of Medicaid Managed Care regions from 11 to nine. However, some regions will be able to increase the minimum and maximum number of allowed plans. Additionally, AHCA will pay provider service networks on a prepaid basis, and designated cancer hospitals will be added as essential providers. Dental services will continue as separately managed care plans. AHCA will be able to award contracts either regionally or statewide.
With Florida home prices skyrocketing, lawmakers approved two measures designed to help “hometown heroes” – including nurses and paramedics – whose tireless dedication carried the state through two years of the pandemic. The new Florida Hometown Hero Housing Program provides up to $100 million to help those workers purchase a home by offering zero-interest loans to provide down payment and closing cost assistance. Lawmakers also placed on the ballot a constitutional amendment that, if approved by the voters, will grant an additional homestead exemption for some of those same professions.
Lawmakers adopted legislation to expand the allowable services using telehealth, including prescribing a wider range of medications. The bill also will allow a telehealth provider to issue a renewal prescription for a controlled substance listed in Schedule III, IV, or V. Currently, telehealth providers are prohibited from prescribing controlled substances through telehealth unless the prescription is for the treatment of a psychiatric disorder, inpatient treatment at a hospital, the treatment of a patient receiving hospice services, or the treatment of a resident in a nursing home facility. The measure narrows this prohibition to the prescribing of only Schedule II controlled substances through telehealth, except under those specific circumstances.
After the nursing home industry cited a shortage of workers and the more diverse health care needs of modern patients, lawmakers changed 20-year-old staffing requirements to lower the minimum number of direct care hours that certified nursing assistants must provide to nursing home residents each day. The legislation allows care provided by other specialized staff – such as mental health counselors and physical therapists – to count toward the required hours. The budget also included a 7% increase in Medicaid reimbursement rates for nursing homes that allow a public review of their financials.
Lawmakers addressed the transportation to commitment facilities and whether mental health patients can commit themselves, now allowing law enforcement to determine whether such transport (including of children as young as 5) is necessary. Also, parents of minors will now be allowed to forgo a court review and voluntarily check their children into facilities as long as the parent and child agree.
A bill banning abortions after 15 weeks, with exceptions only for serious risk to the pregnant woman or fatal fetal abnormality, was passed and is expected to be signed by Gov. DeSantis.
Lawmakers passed a bill to penalize companies transporting undocumented immigrants into Florida, expanding a 2019 law that sought to ban “sanctuary cities.”
Lawmakers passed a measure to create a new office in the Department of State to investigate voting irregularities. The bill also would raise penalties for violating elections laws, including ballot harvesting.
The session concluded with lawmakers passing a $658 million tax relief package to relieve consumers and, to a lesser extent, businesses. The plan establishes four sales tax holidays, including a one-month $200 million gas tax holiday in October, focusing on non-recurring tax cuts that help individual taxpayers.
Although legislators heard a constant stream of complaints from constituents about rising property insurance rates across the state, they did not approve any proposals to address the problem. Gov. DeSantis said he would welcome a special session on the matter but warned that citizens should be aware that in an era of rising inflation, not only insurance rates but also gas, groceries, and utilities are expected to continue to increase.
This year’s legislative session included controversial bills involving restrictions on teaching about race-related issues, sexual orientation, and gender identity in schools. Lawmakers passed a bill to prevent the teaching of critical race theory in schools, along with a measure that prohibits classroom discussion about sexual orientation or gender identity in grades K-3, and confines such discussions to “age-appropriate” content in higher grades.