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Lawmakers Edge Closer On Health Budget

Apr 26, 2019
Originally published on April 26, 2019 9:17 am

Florida lawmakers are inching closer to reaching agreement on how more than $10 billion in state money should be spent on health and human services. 

House and Senate negotiators made progress Wednesday night in resolving differences in their health-care spending plans, as the House agreed, among other things, to alter positions on Medicaid funding for hospitals and for programs that serve people with developmental disabilities.

Despite the progress, differences remained.

While the House agreed with the Senate to a $48 million increase for the Medicaid developmental-disabilities program known as iBudget Florida, the chambers haven’t agreed on whether to increase wages for direct-care staff in residential facilities.

The Senate wants to spend $41.7 million to increase the average wage from $9.50 an hour to $11 an hour. The House hasn’t funded the increase.

“This is critically needed as we are having difficulty competing with big-box retail stores and fast-food restaurants for employees,” said Jim DeBeaugrine, a lobbyist and former director of the state Agency for Persons with Disabilities. “These businesses offer better wages and a much less stressful work environment than our residential facilities. “

On hospital funding, the House changed its original spending plan in two ways. First, it agreed to back off a proposed 3 percent cut in Medicaid rates for hospitals, a proposal that amounted to $112 million.

The House also agreed to take $24 million from what some call a “critical care fund” and use that to increase base rates for all hospitals.

The moves bring the House closer to the Senate, which did not propose cutting hospital rates. The Senate plan, however, proposed wiping out the “critical care fund” and using the $318 million that was in it to increase the base rates for all hospitals.

In a statement to The News Service of Florida, the Safety Net Hospital Alliance of Florida said it was still reviewing the details.

“But, any cut to critical care funding for our state’s top performing hospitals and top children’s hospitals would be harmful. The institutions that provide the most exceptional care in Florida to our most vulnerable ---- newborns and children on Medicaid --- should benefit from additional state investment, not be subjected to budget cuts,” said Justin Senior, chief executive officer of the alliance, which represents public, teaching and children’s hospitals.

The money traditionally has been used to increase payments to hospitals that treat large numbers of Medicaid patients, such as Jackson Memorial Hospital in Miami and hospitals that make up the Broward Health network.

“It’s still an ongoing discussion,” House Speaker Jose Oliva, R-Miami Lakes, said when asked about hospital negotiations. “The payment enhancements are still a point of contention, so it’s an ongoing discussion.”

The 2019 legislative session is slated to end May 3. While legislators will consider hundreds of bills, they only are required to pass one: the budget. The House and Senate earlier this month each passed proposed spending plans.  Now, negotiators are hammering out the differences.

House-Senate conference committee has been given until Thursday night to settle as many differences as they can. Anything that’s not resolved by Thursday night will be negotiated by Senate Appropriations Chairman Rob Bradley, R-Fleming Island, and House Appropriations Chairman Travis Cummings, R-Fleming Island.

If they cannot solve the differences, the issues will be bumped upstairs to Oliva and Senate President Bill Galvano, R-Bradenton.

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