A House plan to overhaul the Florida Department of Health will no longer shift major public-health responsibilities to counties — but other proposed changes continued to draw objections Tuesday, reports the News Service of Florida.
The House Appropriations Committee approved the overhaul bill (HB 1263), after eliminating the creation of a “decentralized” public health system. That proposal called for funneling block grants to counties, which would take over health duties and potentially thousands of employees from the state.
Bill sponsor Matt Hudson, R-Naples, said he decided to offer the amendment after hearing concerns from counties and Gov. Rick Scott’s administration. The Department of Health and lobbyists for counties and health groups praised the move.
“It does take us closer to where we need to be going,” said Rep. Mia Jones, D-Jacksonville.
Nevertheless, critics called for further changes in the wide-ranging bill, as the appropriations committee approved it in a 12-8 party-line vote.
For example, two speakers questioned part of the bill that calls for closing the A.G. Holley state tuberculosis hospital in Palm Beach County. The idea, which has been discussed for years, would lead to contracting with another provider to treat tuberculosis patients.
Longtime public-health physician Landis Crockett said A.G. Holley has experts in dealing with issues such as cases of drug-resistant tuberculosis.
“We’re trading essentially a team of seasoned veterans for an unknown,” Crockett said.
But Hudson said 46 states are able to manage tuberculosis patients without running hospitals similar to A.G. Holley.
The bill is part of a three-year effort by Hudson and other House leaders to try to revamp the Department of Health. Hudson, who is chairman of the House Health Care Appropriations Subcommittee, argues the agency needs to become more focused.
Senators also started moving forward last week with a similar bill, which did not include the decentralization idea. That bill (SB 1824) could be heard Wednesday in the Senate Governmental Oversight and Accountability Committee.
The changes in the House bill range from revising the legal duties of the state surgeon general to repealing a statewide septic-tank inspection program, which lawmakers approved in 2010.
One of the main concerns of public-health advocates is that the bill would reduce the department’s emphasis on disease-prevention programs. Chris Nuland, a lobbyist for the Florida Public Health Association, said his group has a “fundamental difference of opinion” with the bill’s approach to prevention.
Another issue that has drawn scrutiny is possible changes to the Children’s Medical Services program, which serves children with complex health-care needs.
Sam Bell, a lobbyist for the Florida Pediatric Society, said he was concerned the bill would limit services to children who have “serious” health conditions. He said he was concerned that could disqualify about 25 percent of children who get services through the program.
“I am not sure what exactly seriously ill means in the legislative context,” Bell said.
But Hudson said the program was created to provide care to children with serious illnesses, not simply chronic conditions that can be treated elsewhere.
“The point of CMS is to drive more specialty care to children,” he said.
The Department of Health said last week that it preferred the Senate version of the overhaul to the House version. But the department issued a statement Tuesday that was more upbeat, after the appropriations committee eliminated the decentralization idea.
“We are pleased with the amendment filed today and believe that Representative Hudson is making great strides in helping the department streamline and cut out bureaucratic stops while simultaneously being fair to the counties,” the statement said.