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Date ArticleType
10/29/2021 4:00:00 AM Emergency Management Notices

The FHA Pulse - October 29, 2021

 
IN THIS ISSUE
BREAKING: Governor DeSantis Calls Legislative Special Session for November 15-19
Late Friday Governor Ron DeSantis called the legislature into Special Session November 15-19. While the Governor released a number of bullets regarding the focus of the session, in the absence of specific legislation it is difficult to draw any conclusions regarding the impact on hospitals. As you may recall, last week, in anticipation of the Governor’s action, the FHA Board of Trustees held a robust discussion about potential state legal challenges and a Special Session. The Board also acknowledged that once federal rules become official, most hospitals will have little choice but to follow the federal mandates, unless instructed otherwise by the courts,
The Governor is calling on the Legislature to consider legislation that will: 
  • Protect current and prospective employees against unfair discrimination on the basis of COVID-19 vaccination status and ensure robust enforcement for this protection;
  • Ensure that educational institutions and government entities are prohibited from unfairly discriminating against current and prospective employees, students, and residents on the basis of COVID-19 vaccination status;
  • Ensure that employees improperly denied employment on the basis of COVID-19 vaccination status can be eligible for reemployment benefits and, if needed, ensure that employees injured by a COVID-19 vaccination taken pursuant to a company policy are covered by workers’ compensation;
  • Appropriate a sufficient amount of funds to investigate complaints regarding COVID-19 vaccination mandates and to take legal action against such mandates, including mandates imposed by the Federal Government;
  • Clarify that the Parents’ Bill of Rights, Chapter 1014, Florida Statutes, vests the decision on masking with parents, not government entities, and that schools must comply with Department of Health rules that govern student health, including rules that ensure healthy students can remain in school; 
  • Limit mandates by school districts on students or employees regarding COVID-19 and related mitigation measures;
  • Provide adequate enforcement mechanisms to ensure that Florida law is followed and the rights of parents are honored;
  • Direct the State to evaluate whether it should assert jurisdiction over occupational safety and health issues for government and private employees;
  • Repeal the authority for the State Health Officer to order forced injections or vaccinations under Section 381.00315, Florida Statutes, originally enacted in 2002; and
  • Create as necessary public records exemptions related to complaints and investigations described herein.
The Florida Hospital Association team will continue tracking developments on the upcoming Special Session.
 
Governor Ron DeSantis Announces Lawsuit Against Biden Administration's Unconstitutional Vaccine Mandates
On Thursday, Governor Ron DeSantis announced a lawsuit against the Biden Administration's order requiring employees of federal contractors to be vaccinated by December 8. The lawsuit shows Governor DeSantis following through on his promise to take legal action against federal overreach and make Florida the first state in the nation to hold the President accountable. The lawsuit seeks an immediate end to the unlawful requirement that federal contractors ensure that all employees have received a mandated injection. The lawsuit does not target CMS or OSHA expected regulations that would apply to employers, hospitals, and health care providers; this lawsuit strictly focuses on the federal contractor regulations.
 
DeSantis Administration AG Sues President and NASA Over Vaccine Mandate 
On Thursday, Attorney General Ashley Moody filed a lawsuit in the United States Court’s Middle District of Florida, challenging the Biden administration’s mandate that all federal contractors, including some of Florida’s state employees, be vaccinated against COVID-19.  The lawsuit, which seeks to hold unlawful the executive order (EO) and subsequent rules enforcing the EO, challenges the mandate based on violations of federal procurement law and the Administrative Procedures Act. The lawsuit does not deal with expected vaccine mandates from OSHA or CMS; however, it may provide a blueprint, citing procedural misfeasance, for the approach the DeSantis administration will take once the two agencies release their rules.
 
Federal Reconciliation Bill Proposes Significant Cut to DSH and FL Low-Income Pool  
On Thursday, the House of Representatives Rules Committee released draft legislation to move forward the Build Back Better Act (BBB) – the budget bill to implement the Senate’s budget reconciliation instructions. The Rules Committee draft of the BBB represents weeks of negotiations between the White House and House and Senate members.
 
Notably, the draft language includes an extension of the Affordable Care Act Marketplace tax credits through 2025 for those in the coverage gap in states that have not expanded Medicaid. However, the BBB also penalizes non-expansion states by reducing their DSH allotment from 100 to 87.5% until they expand their Medicaid programs, and eliminated substantially all uncompensated care from 1115 waiver programs like Florida’s. This carrot and stick method to provide coverage and incentivize Medicaid expansion creates a great deal of uncertainty for patients who may not have coverage after the marketplace expansion expires, and hospitals who are the sole target of the proposed reimbursement cuts. FHA will be working with our congressional delegation to express our concern with this provision of the BBB.
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Looking Ahead: Committee Week Schedule for November 1 – November 5 
Next week, the Florida Legislature will return to Tallahassee for another committee week ahead of the 2022 legislative session. Some notable bills and committee presentations on the agenda include:
  • Tuesday, November 2 - An overview by DCF and panel discussion on Behavioral Health in the Senate Children, Families, and Elder Affairs Committee. 
    • FHA member Melissa Larkin-Skinner, CEO of Cornerstone, will participate on Tuesday’s panel to discuss Florida’s behavioral health system, Baker & Marchman Acts, and more. 
  • Wednesday, November 3 - SB 252 by Senator Brodeur on health care cost savings & shoppable services is up in the Senate Banking & Insurance Committee. 
    • This bill would have the state’s shoppable services provisions mirror the 500 shoppable services identified in the federal transparency rule. This addition would ensure that these services are included in the state’s shared savings program. We continue to evaluate the administrative burden that this change will have on our hospitals and how we can work to ensure the appropriate information is being reported to the state.
  • Wednesday, November 3 - SB 330 by Senator Brodeur regarding Medicaid reimbursement for patient evaluation services will be heard in the Senate Health Policy Committee.
    • This bill would authorize Medicaid to reimburse for patient evaluation services. FHA members have been utilizing this method of care due to challenges during the pandemic and have become increasingly sophisticated in their approach to remote patient monitoring and evaluation.
  • Wednesday, November 3 – SB 296 by Senator Garcia regarding Health Care Expense will be heard in Senate Health Policy Committee.
    • The proposed legislation will require hospitals to establish, update, and make public the facilities’ standard charges for services already defined by federal transparency regulations or be subject to an additional $500 fine by the state. While we support transparency measures, we also believe that there is limited value in looking at negotiated rates for the commercially insured instead of out-of-pocket expenses.
    • Additionally, the bill contains prohibitions on medical debt that may be reported by consumer credit agencies.  
  • Wednesday, November 3 - AHCA presentations to the Legislature:
    • Senate Appropriations Subcommittee on Health & Human Services – Secretary Marstiller will provide an update on Medicaid Hospital DPP, reviewing the elements of the program and its implementation throughout the state.
    • House Finance & Facilities Subcommittee – Deputy Secretary Tom Wallace will deliver a presentation on Medicaid Quality Measures.
Please view FHA’s weekly legislative report to read recently filed legislation, and stay tuned for updates on these key hearings in next week’s Capitol Update.
 
 
AHCA Holds Negotiated Rulemaking Conference Related to NICU Licensing 
On Monday and Tuesday, the Agency for Health Care Administration (AHCA) undertook a negotiated rulemaking process to establish the licensing requirements for neonatal intensive care units (NICU). The rulemaking committee, made up of 15 hospital representatives and two agency reps, uniformly agreed that the state should establish four levels of care and proceeded to define the services and providers necessary to receive licensure in levels II, III, and IV. The negotiated rulemaking process results from multiple lawsuits and revisions to NICU licensure rules initially proposed in 2018. A key sticking point in the challenged rules required the highest level NICUs to maintain continuous availability of pediatric cardiac services — the committee agreed to remove those requirements. Instead of volume requirements, Level III and IV NICUs must participate in the Vermont Oxford Network. The final rule will recommend that the state enhance the Florida Perinatal Quality Collaborative to phase out reliance on the Vermont Oxford Network ultimately.
 
 
House Energy and Commerce Health Subcommittee Meets to Discuss Health Care Workforce Issues
On October 26, the House Energy and Commerce Committee held a hearing entitled, "Caring for America: Legislation to Support Patients, Caregivers, and Providers." The hearing focused on seven pieces of legislation aimed at fostering a more robust, diverse, and supported public health workforce. The Dr. Lorna Breen Health Care Provider Protection Act H.R. 1667, which aims to prevent suicide, burnout, and mental and behavioral health conditions among health care professionals, received notable bipartisan support. The committee also discussed a Florida Hospital Association priority, H.R. 4407, which would fix a technical glitch by CMS to prevent large cuts to hospital-based nursing programs. 
 
The Florida Commission on Mental health and Substance Abuse Holds Behavioral Health System Workshop
On October 20, 2021, the Florida Commission on Mental health and Substance Abuse held a public meeting/workshop on the current status of Florida's behavioral health system. Members of the commission are appointed by the Governor, President of the Senate, and Speaker of the House. FHA member representatives on the commission include Dr. Jay Reeve, Chair, and Melissa Larkin-Skinner, FHA Behavioral Health Council member.
 
Member presentations covered process maps of behavioral health services, Medicaid health plans, and available data sources. Dr. Jay Reeve recommended a data task force to conduct a prevalence study and identify targeted solutions to enhance the coordination and integration of mental health care. Data collected through an epidemiological mapping project would allow the commission to develop targeted changes to existing laws, rules, and policies.

The next Commission meeting is on November 16. For more information on the commission, please visit the Commission website.
 
FHA Community Benefit Survey
The Florida Hospital Association is developing its annual statewide community benefit report to "tell the Florida hospital story" and help stakeholders understand the important work hospitals provide beyond delivering high-quality care. In addition to our regular community benefit financial data and stories, this year's report will focus on COVID-19 related activities. Together, with your help, we will be able to illustrate the huge financial and logistical task of these community benefit endeavors for the public and lawmakers alike.
 
FHA Elects New Board of Trustees Officers
The Florida Hospital Association member institutions elected the following officers at the 2021 Annual Business Meeting:
  • Chair Tom VanOsdol president and CEO of Ascension Florida and Gulf Coast
  • Vice-chair/Chair-elect Bo Boulenger,  president and COO of Baptist Health South Florida
  • Board Treasurer Gino Santorio, president and CEO of Mount Sinai Medical Center of Greater Miami
  • Tommy Inzina, CEO of BayCare Health System, and Dr. Larry Antonucci, CEO of Lee Health, were elected to serve a second term
Thank you Immediate Past Chair Steve Johnson, president and CEO of Health First. Read the full release.
 
Florida Hospital Associations Joins South Florida Hospital and Healthcare Association Golf Outing
 

 
Florida Hospital Association President and CEO Mary Mayhew and SVP of Communications, Marketing, and Education, Marc Lotter, joined the South Florida Hospital and Healthcare Association (SFHHA) annual golf outing this past week in Fort Lauderdale. The event provided a great opportunity for FHA to connect with SFHHA and its members. The event attracted dozens of leaders focused on improving health care and health outcomes in the South Florida region. FHA partnered with leaders from Special Care Unit, a company that partners with hospitals in Florida and around the world, to successfully wean patients off ventilators and reduce readmission. While the team didn't win, a great time was had by all.
 
New Communications Team
The Florida Hospital Association recently hired Juliet Hauser as director of communications. She was previously a senior account executive with the public relations firm Sachs Media. Savannah Kelly, who had been director of communications, is now director of external affairs for Governor DeSantis. Tim Jacques, deputy director of communications, joined the association after five years with the Florida Department of Transportation.
 
The FHAPC 2021 Golf Outing NOW Open to Individuals
The 2021 FHA Golf Outing, held at the iconic TPC Sawgrass Stadium Course in Ponte Vedra on November 15-16, 2021, is now open to individuals! Limited spots are available—sign up below! Additionally, contributions to the FHAPC can be made any time at www.fhapc.org.
 

 
Save the Date for HOSPITAL DAYS! 
The Florida Hospital Association's Hospital Days are coming to the state capitol on January 24 & 25, 2022. Join us to show support for Florida's health care heroes and engage with state lawmakers. Please contact David Mica, Jr. at DavidM@fha.org or 352.222.8700 if you have any questions. 
 

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The FHA Pulse is the Association's regular update that contains articles, information, and our upcoming events. We hope you will enjoy and share among your staff. If you have any questions or content suggestions, please email us at Communications@FHA.org. 
UPCOMING EVENTS
Medicare 101 – 3-part Virtual Series
on November 2, 9, & 12, 2021
FHA Monthly Quality Hot Topics on Wednesday, November 3, 2021, 1:00 pm EDT
 
Workforce Resilience Webinar on November 18, 2021, at 1:00 pm (ET)
 

 

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