FHA and Member Hospitals Advocate on Proposed Florida Building Code Changes
FHA has been coordinating with member hospital staff regarding a proposed change to Florida’s Building Code that would require expensive and impractical facility improvements to hospitals. The proposed change requires hospitals in certain coastal areas to increase the height of their facility’s first floor, which would require millions in infrastructure costs for some FHA members and require entirely rebuilt facilities for others.
FHA submitted comments to the Florida Building Commission within the Department of Business & Professional Regulation to share these concerns and advocate for the withdrawal of this proposal. On Friday, FHA and multiple member hospital staff testified to the Special Occupancy Technical Advisory Committee (TAC) to voice opposition to the proposed change. The TAC unanimously voted to recommend keeping the current law and withdrawing the proposed building code change. FHA is hopeful that the Florida Building Commission will accept these recommendations and will keep members informed on any developments.
Should you have any questions about this issue please contact Michael Williams.
Governor DeSantis Announces Legislation Requiring Hospital Reporting on Illegal Immigrants
Governor Ron DeSantis is proposing broad immigration legislation that includes requirements for hospitals to report on patients’ immigration status and the cost of providing care to illegal immigrants.
In May 2022, the Governor issued an executive order and request for hospital data on the cost of care provided to illegal immigrants for the state fiscal year 2020-2021. The governor’s press release announcing the legislative proposal featured a summary of that data aggregated by the Agency for Healthcare Administration.
Currently, the specifics of the proposed hospital reporting requirements are unavailable. FHA will communicate closely with the Governor’s office and our members as the legislation is filed and moves through the legislative process.
House Health Care Appropriations Discusses Hospital Margins
This week, the House Health Care Appropriations Committee heard a presentation from the Agency for Health Care Administration on the hospital’s 2020-2021 financial data pulled from the Florida Hospital Uniform Reporting System (FHURS). The data across all hospitals reveal an average 10% operating margin in 2021, with 73% of hospitals having higher operating margins in 2021 than in 2020.
Anticipating this presentation, FHA shared data collected from our member hospitals earlier this year on cost increases, inflation pressures, and the impact these factors are having on current margins. Based on our more current survey data, the 2021 financial data fails to accurately depict hospitals’ financial situation. Florida hospitals’ operating margins have declined by 5.3% in 2022, primarily due to a 35% increase in total expenses and the impacts of inflation. We have been discussing the survey results with members of the legislature and cautioning them about relying on 2020 and 2021 data.
In our ongoing conversations with lawmakers, we will continue to stress the distinction among investment growth, operating margins, and total margins and the impacts of increases in the costs of workforce, supplies, and pharmaceuticals and of inflation.
Read FHA’s full alert here.
Visit FHA’s New Legislative Session Website
FHA has launched a new microsite, fhacapitolupdate.org, to give members access to all legislative session-related content, collateral, and information. The new site is designed to be easy to use and to encourage member engagement in FHA’s advocacy during the legislative session. Members can visit the Take Action section of the site and immediately contact their lawmaker to express support or opposition to an FHA priority bill. The site also tracks priority bills through the legislative process and provides a calendar of key hearings. Current and archived copies of the Capitol Update will be housed here as will all infographics, reports, summaries, and other documents related to our state advocacy.
House Speaker-backed Tort Reform Legislation makes first committee stop
HB 837 by Fabricio, backed by legislative leadership, Governor DeSantis, and a coalition of business industry trade associations, was reported favorably by the House Civil Justice Subcommittee on Friday. The bill would eliminate one-way attorney fees for all lines of insurance, require transparency in damages by allowing the jury to see the amount generally accepted for a health care service, and revise Florida’s bad faith and contributory negligence laws.
FHA is monitoring this legislation on behalf of our member hospitals both as providers of health care services and as large employers. Any impacts to medical malpractice rates or calculation of damages recoverable for medical treatment will be communicated with legislators and our membership.
Presentations on Florida’s Nursing Education Programs
FHA continues to closely monitor legislative deliberations relating to Florida’s nursing and health care workforce pipeline. We are educating legislators and state agency staff about hospitals’ efforts to partner with educational institutions to assess their regional needs and foster the next generation of qualified caregivers. FHA has also collected and shared current data trends for nurses and allied health professions as well as information about hospitals’ exorbitant workforce cost increases. As part of this advocacy approach, FHA continues to support the initiatives of the Florida Center for Nursing, creative funding programs such as the LINE, PIPELINE, and the Hometown Heroes Housing program, as well as our continued focus on state-level data collection.
The Postsecondary Education & Workforce Subcommittee met on Thursday, February 23rd to hear presentations on nursing education programs. Dr. Rayna Letourneau presented the Florida Center for Nursing’s directives, including a strategic statewide plan for nursing manpower in this state. She also provided an overview of the Nursing Education Report, including faculty recruitment barriers and annual NCLEX passage rates. Dean Usha Menon, Senior Association Vice President with USF Health also presented on their V-CARE BSN Pathway (VBSN). The VBSN pathway was established and funded through a federal grant from 2013 to 2019 as an accelerated four-semester pathway that shortened the time to degree completion for veterans while maintaining academic rigor, clinical quality, and high NCLEX pass rates. To date, 160 veteran students were admitted to the VBSN pathway and 132 have graduated.
Senate Health Policy Approves Several Key Bills
Several FHA-supported bills were approved by the Senate Health Policy Committee on Thursday. SB 298 Telehealth Practice Standards by Senator Boyd would allow for the definition of telehealth to include audio-only phone calls. A bill backed by Americans for Prosperity, FHA advocated for this provision in 2022 before it was removed from the bill at the end of session and looks forward to supporting it again this year. SB 112 – Step Therapy by Senator Harrell would allow AHCA to approve drug products for Medicaid recipients for the treatment of serious mental illness without step-therapy prior authorization under certain circumstances. FHA provided supporting testimony and remains focused on reducing the administrative burden on hospital staff resulting from the payer’s administrative policies. Finally, SB 274 – Nursing Education Pathway for Military Combat Medics passed its second committee stop.
Legislation is filed to Promote Career and Technical Education
Senator Travis Hutson (R-St. Augustine) filed SB 240 focused on furthering ongoing legislative initiatives that promote career and technical education (CTE), with a focus on work-based learning linked to local employment opportunities for Florida students in Grades 6-12. Senator Hutson noted that in 2008, only 803 students in Florida earned national industry certifications in high school. Last year, over 100,000 students earned these work-based credentials across 17 Career and Technical Education Pathways, including health care. The bill provides $100 million for the Workforce Development Capitalization Incentive Grant Program funding to incentivize and promote career and technical education in grades 6-12. The bill also makes changes to the Florida Center for Nursing (FCN)’s section of law by adding a directive to convene various representatives of nurses, health care providers, business and industry, consumers, lawmakers, and educators to review the data analysis prepared for the center and to recommend systemic changes for improvement.
First Lady Casey DeSantis visits USF Health in Tampa
On Thursday, February 23rd, First Lady Casey DeSantis held a roundtable at USF Health in Tampa to unveil the Cancer Connect Collaborative, an expansion of Florida Cancer Connect that will assemble a team of medical professionals to analyze and rethink Florida’s approach to combatting cancer. The Cancer Collaborative will focus on five goals related to data, best practices, innovation, funding, and honesty.
Managed Care Market Share Reports
The Florida Hospital Association Market Share reports for the Second & Third Quarters of 2022 are now available! The data from the reports is based on filings with the Florida Office of Insurance Regulation. We have provided some highlights below, but full reports are attached.
Second Quarter 2022
One-third or 7.7 million Floridians were covered through HMOs as of June 31, 2022, an increase of 6.6% compared to June 31, 2021. With almost 500,000 new HMO members, the overall membership growth was driven primarily by a 386,000 or 10% increase in Floridians enrolled in Medicaid-managed care plans. Medicare enrollment dropped 0.3% during this period, while commercial HMOs increased by almost 100,000 members.
Third Quarter 2022
Enrollment in HMO plans continued to grow in the first quarter of 2022 with 7.8 million Floridians covered as of September 30, 2022. Medicaid HMO members increased by 10.6% or 414,000, the largest contributing factor to the increase. Medicare enrollment dropped 0.8% during this period, while commercial HMOs increased by almost 70,000 members.
Second Quarter 2022 VS Third Quarter 2022
130,000 more Floridians were covered through HMOs as of September 30, 2022, an increase of 1.7% compared to June 31, 2021. Medicaid HMOs were the main driver of this quarter-to-quarter increase with almost 120,000 (2.8% increase) new enrollees along with an increase of over 15,000 in Medicare HMOs. Commercial enrollment declined 0.3% during this period with a decrease of over 5,000 enrollees. Market HMO enrollment penetration increased to 36.5% from 35.9% in the second quarter of 2022.
Newly appointed Commissioner of the Office of Insurance Regulation, Michael Yaworsky, also presented to the House Health Care Regulation Subcommittee regarding health insurance trends on Thursday.
Infection Prevention and Quality Leaders Join FHA’s Statewide Infection Prevention Virtual Training Series
This week, more than 200 infection prevention, quality, and clinical leaders from across the state registered to participate in FHA’s statewide infection prevention virtual training series, “Taking it to the Next Level”. The three-part series is an informative and interactive program designed to support the professional development of practicing infection preventionists in hospitals and communities. The objectives provide the next tier of knowledge and competencies for practicing infection preventionists who are the leaders we rely on for the implementation of effective infection prevention programs that drive a reduction in hospital-acquired infections and improved patient safety. FHA congratulates the program attendees for their successful completion of the program!
National Research Study: Attributes Nurse Leaders Desire in New Graduate Nurses
Nursing Leaders are invited to participate in a national research study to assess what attributes nurse leaders desire in new graduate nurses’ readiness to practice. This is the first known study of its kind, designed to address new domains for nursing education.
Historically, the American Association of Colleges of Nursing (AACN) has provided the educational framework for the preparation of nurses at four-year colleges and universities known as The Essentials. In April 2021, AACN revised The Essentials, proposing that education be presented as competencies and sub-competencies organized within ten domains that represent the essence of professional nursing practice (American Association of Colleges of Nursing, 2021).
Time is of the essence and participation in the national study is needed within the next 30 days! You are encouraged to share this request with your nursing leadership team. To complete this 5-minute survey, please see the letter from the Principal Investigator. Your voice is valuable in shaping nurses of the future.
This research study has been approved by the University of Indianapolis Institutional Review Board for the protection of human participants in research. Approval date: 5/8/2022; Approval # 01644
Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act
The CONNECT for Health Act is designed to improve access for patients to connect with providers and thereby, patient outcomes. The objective is to make telehealth regulation flexibilities permanent and expand telehealth coverage through Medicaid.
The American Hospital Association recently submitted letters to the House and Senate encouraging the Congressional Telehealth Caucus to consider adding provisions that have previously expanded access to care during the public health emergency (PHE).
The updated version of the bill includes new provisions encouraging access to Medicare-related telehealth services and include the following:
- Remove geographic restrictions on telehealth services
- Expand “originating sites” to include the home and other sites
- Repeal in-person visit requirement for behavioral health
- Include a permanent provision to allow Federally Qualified Health Centers and Rural Health Clinics to provide telehealth services
- Reimburse as in-person visits
- Continue payment and coverage for audio-only services
- Establish a Drug Enforcement Administration (DEA) special registration process for prescribing controlled substances via telemedicine
During the PHE, we learned that telehealth works and improves available and timely access to effective, quality care for more individuals.
Public Health Emergency (PHE) 1135 Waivers: CMS Issues Updated Guidance for Providers
On February 9, the Department of Health and Human Services (HHS) announced the Public Health Emergency (PHE) for COVID-19 will end on May 11, 2023. COVID-19 remains a significant priority for the Biden-Harris Administration and over the next several months, the Centers for Medicare & Medicaid Services (CMS) will work to ensure a smooth transition. During the PHE, CMS has used a combination of emergency authority waivers, regulations, enforcement discretion, and sub-regulatory guidance to ensure easier access to care during the PHE for health care providers and their beneficiaries.
Some of the flexibilities that were created during the pandemic were recently expanded by the Consolidated Appropriations Act, 2023. Others, while critical during our initial responses to COVID-19, are no longer needed. CMS has made further updates to our CMS Emergencies Page with useful information for providers – specifically around major telehealth and individual waivers – that were initiated during the Public Health Emergency (PHE).
Please reference the following guidance in response to the PHE ending May 11, 2023:
Provider-specific fact sheets about COVID-19 Public Health Emergency (PHE) waivers and flexibilities: https://www.cms.gov/coronavirus-waivers
Department of Health & Human Services Fact Sheet: https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html
In the coming weeks, CMS will be hosting stakeholder calls and office hours to provide additional information. Please continue to visit the CMS Emergencies Page for continuous updates regarding PHE sunsetting guidance as information becomes available to the public.
Hospital Days 2023
The Florida Hospital Association’s (FHA) Hospital Days are returning to the state capitol on March 15-16, 2023. Join us in Tallahassee to show support for Florida’s health care heroes and engage with state lawmakers. Participants will engage directly with key state lawmakers, participate in our political briefings, and connect with the larger Florida hospital community. Special hotel block reservations can be made here through February 21, 2023. Register to attend Hospital Days now to reserve your spot!
Miami Open Offers Health Care Professionals a Special Invitation
One of the largest tennis tournaments in North America, the Miami Open will be hosted at the Hard Rock Stadium in Miami Gardens from March 22 through April 2, 2023. On Wednesday, March 29 and Saturday, April 1, all hospital staff are invited to attend the Health Care Professionals Day event. Tickets start at $50 each for the weeknight session or $65 for the daytime weekend session. Every health care professional who purchases a ticket and attends will receive a special Miami Open branded scrub top.
FHA-FHCA-Alliant Health Solutions Readmissions Webinar Series: Importance of Knowing Nursing Home Capabilities
March 7, 2023, 1:00 p.m. -2:00 p.m. ET
Infection Prevention Hot Topics: The Role of the Infection Preventionist in Addressing Health Care Disparities
March 14, 2023, 2:00 p.m. – 3:00 p.m. ET
Antidote Safety Pearls: Don’t Be A Fool, Use Your Antidote Tool: Quick Action Saves Lives
March 31, 2023, 2:00 p.m. – 3:00 p.m. ET
Infection Prevention Series: Fundamentals for the Novice Infection Preventionist
April 11-13, 18-20, 2023, 2:00 p.m. – 4:00 p.m. ET
Responding to a Crisis: An Overview of Lee Health’s Response to Hurricane Ian
April 17, 2023, 12:00 p.m. – 1:00 p.m. ET