2014 Florida Legislative Session Review: Home Care Edition

Finishing this past Friday evening, the 2014 Legislative Session ended with the State House and State Senate passing fewer bills than any year in over a decade. HCAF is here to report on the items that will/would have affected home care that were considered this year. As the Tampa Bay Times reports,  infighting and maneuvering within other sectors in the industry doomed most healthcare bills. Please read below to learn the results of measures aimed at making changes for home health.

Reduction of Quarterly Report to Twice-Per-Year /Elimination of Report Requirement for License-Only Agencies
HCAF has been working diligently to eliminate the unfair and burdensome home health quarterly report. With lawmakers and regulators currently unwilling to completely get rid of the report, we continue to make it easier and less punitive on our members. Last year, HCAF was successful in reducing the fine for missing the reporting deadline from $5,000 to $200 per day. This year, our language that would reduce the report to twice-per-year and require it only for certified agencies died when most other provisions affecting healthcare this year (including  those that would affect assisted living facilities, HIV treatment, scope of practice for nurse practitioners) were added to the bill late on the final day of session. It is very regrettable that this amended was allowed to the bill, creating an omnibus bill that generally spells certain death for a bill. HCAF will return next year seeking full elimination of the quarterly report.

Raising the Medicaid Private-Duty LPN Rate for PPEC Patients
Without a rate increase in over 27 years, providing Medicaid home health in Florida has become cost prohibitive to most agencies. This year, the budget process began with the Senate Health Appropriation committee suggesting a 20% increase to the rate and the House Health Appropriations Committee supporting 10%. During the conference committee process, the House position was accepted by the Senate and the item was closed out at 10%. In an unusual move, during the full Budget Conference consideration of items that were not agreed upon by the House and Senate health subcommittees, the LPN rate was reopened and slashed by half, with the remainder used to pay for other items in AHCA’s budget. This was an incredibly disrespectful action carried out against home care, all on a Sunday evening. These medically fragile children are some of home care’s neediest patients and this increase would go a long way to assisting agencies in being able to better cover costs when treating them now and in the future. To cut a non-bump item at the full Budget Conference level is not the way the budget process is supposed to work and HCAF strongly condemns this maneuver.

Raising the Medicaid Private-Duty LPN Rate
Without a rate increase in over 27 years, providing Medicaid home health in Florida has become cost prohibitive to most agencies. Although the legislature approved an increase last year, the measure was vetoed by Governor Rick Scott. This year, the legislature has agreed to over an additional $11 million dollars to increase the Private Duty Nursing rate for LPNs who serve Prescribed Pediatric Extended Care patients. These medically fragile children are some of home care’s neediest patients and this increase would go a long way to assisting agencies in being able to better cover costs when treating them now and in the future.

Eliminating Accreditation Requirements for License-Only Personal Care
An amendment was added to SB 1254 that would eliminate accreditation requirements for non-Medicare/Medicaid certified agencies that do not provide any skilled care. This would have a large impact on this sector of the industry, due to the large costs of earning and maintaining accreditation In addition this requirement is a significant hurdle for those non-skilled, non-certified providers who wish to sell their businesses. This bill, which included the quarterly report language died on the final day when an amendment turned it into an omnibus healthcare bill.

Nurse Registries Business Model Clarification
One measure that passed will clarify the Nurse Registry business model within Florida Statute. Specifically, it defines workers as independent contractors that are not employees of the registry. HB1179 passed both chambers and has been sent to the Governor for approval. While HCAF supports our Nurse Registry members, we feel this is a matter that will be decided at the Federal level and that such actions on the state level will have little or no impact. However, HCAF will continue its vigorous opposition in the national arena against certain aspects of the ACAEmployer Mandate and the pending change to the Companionship Exemption.

Expanding Access to Telemedecine and Creating a Regulatory Framework for its Use

A final item HCAF was in support of was a telemedicine bill that would have helped expand access to telehealth in Florida. Legislators opened session by calling this an incredibly important measure in order to improve access to healthcare for Floridians amidst the growing shortage of doctors. Unfortunately, infighting between different healthcare sectors lead tot his item dying once it was included in the package attached to the quarterly report language bill.

HCAF will continue to work for measures that will help our industry. In addition to planned items, we look to our members for suggestions on legislative changes at the state level that would help and expand home care in our state.

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